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WALGREEN EASTERN CO., INC.
CH013240 KATAHDIN VALLEY HEALTH CENTER
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Covered Entity Details
Entity Name
KATAHDIN VALLEY HEALTH CENTER
Subdivision Name
KATAHDIN VALLEY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH013240
Entity Address
30 Houlton St
Patten, ME 04765
Grant Number
H80CS00488
Participating Start Date
1/1/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #18307
720 CENTRAL ST
MILLINOCKET, ME 04462
Pharmacy Comments
Contract Details
Approval Date
1/31/2018
Contract Begin Date
1/31/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/10/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Claudette Humphrey, CEO
(207) 538-3700 Ext: 320
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/31/2018
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