Contract Pharmacy Details

WALGREEN EASTERN CO., INC.
CH014580 PENOBSCOT COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

PENOBSCOT COMMUNITY HEALTH CENTER, INC.

Subdivision Name

BREWER MEDICAL CENTER

Type

HRSA-Funded Health Center

340B ID

CH014580

Entity Address

735 WILSON ST
BREWER, ME 04412

Grant Number

H80CS04291

Participating Start Date

1/1/2005

Last Recertification Date

3/6/2025

Pharmacy Details

Pharmacy Name

WALGREEN EASTERN CO., INC.

Pharmacy Address

RITE AID #04149
254 MAIN ST
BELFAST, ME 04915

Pharmacy Comments

Contract Details

Approval Date

2/9/2018

Contract Begin Date

2/21/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/8/2018
Pharmacy closed

Contacts

Covered Entity Signing Official

Lorelle Dwyer, President & CEO
(207) 992-9200

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

2/9/2018

340B Drug Pricing Program Database