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WALGREEN EASTERN CO., INC.
CHC00630-00 EASTPORT HEALTH CARE INC
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Covered Entity Details
Entity Name
EASTPORT HEALTH CARE INC
Subdivision Name
EASTPORT HEALTH CARE, INC.
Type
HRSA-Funded Health Center
340B ID
CHC00630-00
Entity Address
30 Boynton St
Eastport, ME 04631-1306
Grant Number
H80CS00630
Participating Start Date
7/1/2015
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #17481
144 DUBLIN ST
MACHIAS, ME 04654
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
Holly Gartmayer-DeYoung, CEO
(207) 853-4045
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/31/2018
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