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BEDARD PHARMACY, INC.
DSH200024 CENTRAL MAINE MEDICAL CENTER
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Covered Entity Details
Entity Name
CENTRAL MAINE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH200024
Entity Address
300 MAIN STREET
LEWISTON, ME 04240-4500
Medicare Provider Number
200024
Participating Start Date
4/1/2022
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
BEDARD PHARMACY, INC.
Pharmacy Address
359 MINOT AVE STE B
AUBURN, ME 04210-4329
Pharmacy Comments
Contract Details
Approval Date
7/8/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2016
Contacts
Covered Entity Signing Official
Philippe Morissette, VP of Finance
(207) 795-2972
Contract Pharmacy Representative
Michael Nadeau, President
(207) 786-0138
Signed By Date
7/8/2015
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