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WALGREEN EASTERN CO., INC.
CAH201310-00 BRIDGTON HOSPITAL
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Covered Entity Details
Entity Name
BRIDGTON HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH201310-00
Entity Address
10 HOSPITAL DRIVE
BRIDGTON, ME 04009
Medicare Provider Number
201310
Participating Start Date
8/31/2010
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #19162
698 MINOT AVE
AUBURN, ME 04210
Pharmacy Comments
Contract Details
Approval Date
1/25/2018
Contract Begin Date
1/30/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sean Cheetham, Taxation Manager
(207) 795-7533
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/25/2018
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