340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-2140
CAH301307-00 MaineHealth Memorial Hospital
Print
Covered Entity Details
Entity Name
MaineHealth Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH301307-00
Entity Address
3073 White Mountain Hwy
North Conway, NH 03860-7101
Medicare Provider Number
301307
Participating Start Date
10/1/2011
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2140
Pharmacy Address
46 NORTH SOUTH RD
NORTH CONWAY, NH 03860
Pharmacy Comments
Contract Details
Approval Date
4/2/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/10/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Scott McKinnon, CEO
(603) 356-5461 Ext: 2110
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
4/2/2015
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session