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WALGREENS SPECIALTY PHARMACY, LLC
CAH201305-00 Calais Community Hospital
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Covered Entity Details
Entity Name
Calais Community Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH201305-00
Entity Address
24 HOSPITAL LANE
CALAIS, ME 04619
Medicare Provider Number
201305
Participating Start Date
9/28/2010
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
WALGREENS SPECIALTY PHARMACY, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #15438
41460 HAGGERTY CIR S
CANTON, MI 48188
Pharmacy Comments
Contract Details
Approval Date
1/10/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Diane Maheux, CHIEF FINANCIAL OFFICER
(207) 454-9229
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/10/2018
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