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RITE AID OF MAINE, INC.
HV00729 Health Equity Alliance (HEAL)
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Covered Entity Details
Entity Name
Health Equity Alliance (HEAL)
Subdivision Name
Type
Ryan White Part C
340B ID
HV00729
Entity Address
5 Long Lane
Suite 1
Ellsworth, ME 04605
Grant Number
H76HA00729
Participating Start Date
4/1/2017
Last Recertification Date
2/11/2025
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
RITE AID OF MAINE, INC.
Pharmacy Address
RITE AID #3293
226 UNION STREET
BANGOR, ME 04401
Pharmacy Comments
Contract Details
Approval Date
4/18/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/31/2018
Ownership change
Contacts
Covered Entity Signing Official
Kenney Miller, Executive Director
(207) 667-3506 Ext: 13
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
4/18/2017
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