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WALGREEN EASTERN CO., INC.
RRC200024-00 CENTRAL MAINE MEDICAL CENTER
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Covered Entity Details
Entity Name
CENTRAL MAINE MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC200024-00
Entity Address
300 MAIN STREET
LEWISTON, ME 04240-4500
Medicare Provider Number
200024
Participating Start Date
10/1/2017
Last Recertification Date
9/13/2021
Entity Termination Date
4/1/2022
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #11373
403 WATER ST.
AUGUSTA, ME 04330
Pharmacy Comments
Contract Details
Approval Date
1/8/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Philippe Morissette, VP of Finance
(207) 795-2972
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/8/2018
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