Contract Pharmacy Details

RITE AID OF MAINE, INC.
CAH201300-00 BLUE HILL MEMORIAL HOSPITAL

Covered Entity Details

Entity Name

BLUE HILL MEMORIAL HOSPITAL

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH201300-00

Entity Address

57 WATER STREET
BLUE HILL, ME 04614

Medicare Provider Number

201300

Participating Start Date

1/1/2011

Last Recertification Date

9/9/2024

Pharmacy Details

Pharmacy Name

RITE AID OF MAINE, INC.

Pharmacy Address

RITE AID #4171
220 US ROUTE 1 STE 1
PO BOX B1
BUCKSPORT, ME 04416

Pharmacy Comments

Contract Details

Approval Date

4/25/2013

Contract Begin Date

7/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/25/2018
Ownership change

Contacts

Covered Entity Signing Official

SCOTT OXLEY, INTERIM CFO
(207) 374-3414

Contract Pharmacy Representative

Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217

Signed By Date

4/25/2013

340B Drug Pricing Program Database