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MAXI GREEN, INC.
CHC11353-09 SPRINGFIELD MEDICAL CARE SYSTEMS INC
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Covered Entity Details
Entity Name
SPRINGFIELD MEDICAL CARE SYSTEMS INC
Subdivision Name
Springfield Health Center
Type
HRSA-Funded Health Center
340B ID
CHC11353-09
Entity Address
100 River St
Springfield, VT 05156-2930
Grant Number
H80CS12873
Participating Start Date
4/1/2012
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
MAXI GREEN, INC.
Pharmacy Address
RITE AID #10313
55 SPRINGFIELD PLAZA RD
SPRINGFIELD, VT 05156-2911
Pharmacy Comments
Contract Details
Approval Date
9/26/2012
Contract Begin Date
9/26/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott Whittemore, Chief Financial Officer
(802) 885-7344
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
8/29/2012
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