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MAXI DRUG NORTH, INC.
CAH301303-07 WEEKS MEDICAL CENTER
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Covered Entity Details
Entity Name
WEEKS MEDICAL CENTER
Subdivision Name
Weeks Medical Center-Colebrook RHC
Type
Critical Access Hospital
340B ID
CAH301303-07
Entity Address
141 Corliss Lane
Colebrook, NH 03576-3206
Medicare Provider Number
301303
Outpatient Facility Provider Number
303991
Participating Start Date
7/1/2014
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
MAXI DRUG NORTH, INC.
Pharmacy Address
RITE AID #10287
200 PLEASANT STREET
BERLIN, NH 03570
Pharmacy Comments
Contract Details
Approval Date
10/13/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/26/2018
Ownership change
Contacts
Covered Entity Signing Official
CELESTE PITTS, Vice President of Finance
(603) 788-5321
Contract Pharmacy Representative
Rite Aid Corp.
Wendy Barnes, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
10/13/2014
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