Contract Pharmacy Details

CMMC PHARMACY
CAH201306-00 RUMFORD HOSPITAL

Covered Entity Details

Entity Name

RUMFORD HOSPITAL

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH201306-00

Entity Address

420 Franklin Street
RUMFORD, ME 04276

Medicare Provider Number

201306

Participating Start Date

8/31/2010

Last Recertification Date

8/26/2024

Pharmacy Details

Pharmacy Name

CMMC PHARMACY

Pharmacy Address

12 HIGH ST
LEWISTON, ME 04240-7676

Pharmacy Comments

Contract Details

Approval Date

4/14/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Philippe Morissette, VP of Finance
(207) 795-2972

Contract Pharmacy Representative

Kristin Maguire, Pharmacy Manager
(207) 795-8106

Signed By Date

4/14/2014