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WALGREEN EASTERN CO., INC.
CAH301310-00 ANDROSCOGGIN VALLEY HOSPITAL , Inc.
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Covered Entity Details
Entity Name
ANDROSCOGGIN VALLEY HOSPITAL , Inc.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH301310-00
Entity Address
59 PAGE HILL ROAD
BERLIN, NH 03570-3542
Medicare Provider Number
301310
Participating Start Date
9/29/2010
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #17583
173 PLEASANT ST
BERLIN, NH 03570
Pharmacy Comments
Contract Details
Approval Date
1/31/2018
Contract Begin Date
1/31/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Peterson, President
(603) 326-5602
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/31/2018
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