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WALGREEN EASTERN CO., INC.
CAH201304-00 MOUNT DESERT ISLAND HOSPITAL
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Covered Entity Details
Entity Name
MOUNT DESERT ISLAND HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH201304-00
Entity Address
10 WAYMAN LANE
BAR HARBOR, ME 04609
Medicare Provider Number
201304
Participating Start Date
9/29/2010
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #19967
34 COTTAGE ST
BAR HARBOR, ME 04609-1896
Pharmacy Comments
Contract Details
Approval Date
2/2/2018
Contract Begin Date
2/2/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christina J. Maguire, President/CEO
(207) 288-5082 Ext: 1330
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
2/2/2018
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