340B Drug Pricing Program Database


RRC300012-00 ELLIOT HOSPITAL (Active) - information as of 5/2/2025 10:35:28 PM

Main Details
ELLIOT HOSPITAL
Rural Referral Center
No
RRC300012-00
300012


Additional Details
Active
7/12/2024
10/1/2024
8/28/2024

Contacts

Elliot Hospital
Joseph Tate Curti, COO
(603) 663-2082

Elliot Hospital
Michelle Marie Andrade, 340B Program Manager
(603) 663-2430

Addresses

1 ELLIOT WAY
MANCHESTER, NH 03103

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

No
Shipping Addresses

Elliot Hospital
1 Elliot Way
Manchester, NH 03103

Elliot Pharmacy at River's Edge
175 Queen City Avenue
Suite 1
Manchester, NH 03101

Elliot Hospital Pharm
1 Elliot Way
Manchester, NH 03103

Elliot Pharmacy at Bedford
25 Leavy Drive
Bedford, NH 03110

Safecor Health, LLC
317 New Boston Street
Suite 100
Woburn, MA 01801
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884904/15/202507/01/2025  04/15/2025
Contract DetailACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201004/15/202507/01/2025  04/15/2025
Contract DetailACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750204/15/202507/01/2025  04/15/2025
Contract DetailACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282204/15/202507/01/2025  04/15/2025
Contract DetailACCREDO HEALTH GROUP, INC.4750 E 450 S SUITE A
WHITESTOWNIN4607504/15/202507/01/2025  04/15/2025
Contract DetailACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349204/15/202507/01/2025  04/15/2025
Contract DetailADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101 		ORLANDOFL3280904/10/202507/01/2025  04/10/2025
Contract DetailCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361404/10/202507/01/2025  04/10/2025
Contract DetailCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005604/10/202507/01/2025  04/10/2025
Contract DetailCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621904/10/202507/01/2025  04/10/2025
Contract DetailCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175704/10/202507/01/2025  04/10/2025
Contract DetailCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808304/10/202507/01/2025  04/10/2025
Contract DetailCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700404/10/202507/01/2025  04/10/2025
Contract DetailCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761704/10/202507/01/2025  04/10/2025
Contract DetailCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813304/10/202507/01/2025  04/10/2025
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237404/10/202507/01/2025  04/10/2025
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911904/10/202507/01/2025  04/10/2025
Contract DetailCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870604/10/202507/01/2025  04/10/2025
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005604/10/202507/01/2025  04/10/2025
Contract DetailCVS MANCHESTER NH, L.L.C.DBA: CVS/PHARMACY # 00442 10 WHITEHALL RD.
HOOKSETTNH0310604/10/202507/01/2025  04/10/2025
Contract DetailCVS MANCHESTER NH, L.L.C.DBA: CVS/PHARMACY # 00593 48 E. BROADWAY
DERRYNH0303804/10/202507/01/2025  04/10/2025
Contract DetailCVS MANCHESTER NH, L.L.C.DBA: CVS/PHARMACY # 00741 66 SOUTH RIVER RD.
BEDFORDNH0311004/10/202507/01/2025  04/10/2025
Contract DetailCVS MANCHESTER NH, L.L.C.DBA: CVS/PHARMACY # 02420 177 MAMMOTH ROAD
LONDONDERRYNH0305304/10/202507/01/2025  04/10/2025
Contract DetailCVS MANCHESTER NH, L.L.C.DBA: CVS/PHARMACY # 02257 250 MAMMOTH ROAD
MANCHESTERNH0310904/10/202507/01/2025  04/10/2025
Contract DetailCVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502804/10/202507/01/2025  04/10/2025
Contract DetailESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111204/15/202507/01/2025  04/15/2025
Contract DetailEXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313404/15/202507/01/2025  04/15/2025
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607504/15/202507/01/2025  04/15/2025
Contract DetailEXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801604/15/202507/01/2025  04/15/2025
Contract DetailOPTUM PHARMACY 700, LLC19 CHAPIN RD BLDG D, STE D8
PINE BROOKNJ0705804/15/202507/01/2025  04/15/2025
Contract DetailOPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850704/15/202507/01/2025  04/15/2025
Contract DetailOPTUM PHARMACY 701, LLC1830 S HORNE
MESAAZ8520404/15/202507/01/2025  04/15/2025
Contract DetailOPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713004/15/202507/01/2025  04/15/2025
Contract DetailOPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729804/15/202507/01/2025  04/15/2025
Contract DetailOPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983804/15/202507/01/2025  04/15/2025
Contract DetailPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514604/10/202507/01/2025  04/10/2025
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920304/10/202507/01/2025  04/10/2025
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #48611 141 PREBLE STREET
PORTLANDME0410104/10/202507/01/2025  04/10/2025
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523304/10/202507/01/2025  04/10/2025
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
RRC300012-01ChildRRCELLIOT HOSPITALRIVER'S EDGE- VASCULAR LAB - Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-02ChildRRCELLIOT HOSPITALRIVER'S EDGE- CARDIOVASCULAR HEALTH - Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-03ChildRRCELLIOT HOSPITALRIVER'S EDGE- PULMONARY TESTING - Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-04ChildRRCELLIOT HOSPITALRIVER'S EDGE- PULMONARY REHAB - Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-05ChildRRCELLIOT HOSPITALELLIOT SENIOR HEALTH CENTER - Primary Care138 Webster StreetManchesterNHActive
RRC300012-06ChildRRCELLIOT HOSPITALRIVER'S EDGE- WOUND CENTER - Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-07ChildRRCELLIOT HOSPITALRIVER'S EDGE MRI - Radiology185 Queen City AvenueManchesterNHActive
RRC300012-08ChildRRCELLIOT HOSPITALLONDONDERRY MRI - Radiology40 Buttrick RoadLondonderryNHActive
RRC300012-09ChildRRCELLIOT HOSPITALELLIOT MEDICATION CLINIC- RIVER'S EDGE - CC185 Queen City AvenueManchesterNHActive
RRC300012-10ChildRRCELLIOT HOSPITALELLIOT MEDICATION CLINIC- RAYMOND - CC15 Freetown Road, Ste 8RaymondNHActive
RRC300012-11ChildRRCELLIOT HOSPITALELLIOT MEDICATION CLINIC- SENIOR HEALTH CENTER - CC138 Webster StreetManchesterNHActive
RRC300012-12ChildRRCELLIOT HOSPITALELLIOT MEDICATION CLINIC- LONDONDERRY - CC40 Buttrick RoadLondonderryNHActive
RRC300012-13ChildRRCELLIOT HOSPITALELLIOT URGENT CARE- BEDFORD - Urgent Care25 Leavy DriveManchesterNHActive
RRC300012-14ChildRRCELLIOT HOSPITALELLIOT URGENT CARE- RIVER'S EDGE - Urgent Care185 Queen City AvenueManchesterNHActive
RRC300012-15ChildRRCELLIOT HOSPITALELLIOT URGENT CARE- LONDONDERRY - Urgent Care40 Buttrick RoadLondonderryNHActive
RRC300012-16ChildRRCELLIOT HOSPITALELLIOT BEHAVIORAL HEALTH - Partial Hospital Program300 Hanover StreetManchesterNHActive
RRC300012-17ChildRRCELLIOT HOSPITALRIVER'S EDGE- RHEUMATOLOGY - PBB Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-18ChildRRCELLIOT HOSPITALRIVER'S EDGE- GENERAL SURGERY - PBB Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-19ChildRRCELLIOT HOSPITALRIVER'S EDGE- PULMONARY MEDICINE - PBB Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-20ChildRRCELLIOT HOSPITALRIVER'S EDGE- PLASTIC & RECONSTRUCTIVE SUGERY - PBB Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-21ChildRRCELLIOT HOSPITALRIVER'S EDGE- ORTHOPEDIC SURGICAL SPECIALISTS - PBB Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-22ChildRRCELLIOT HOSPITALRIVER'S EDGE- NEUROLOGY - PBB Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-23ChildRRCELLIOT HOSPITALRIVER'S EDGE- BREAST HEALTH - PBB Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-24ChildRRCELLIOT HOSPITALRIVER'S EDGE- GASTROENTEROLOGY - PBB Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-25ChildRRCELLIOT HOSPITALELLIOT PRIMARY CARE- RIVERSIDE - PBB Primary Care20 Chambers Drive, Suite 2200HooksettNHActive
RRC300012-26ChildRRCELLIOT HOSPITALRIVER'S EDGE- PAIN MANAGEMENT - Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-27ChildRRCELLIOT HOSPITALRIVER'S EDGE- INTERVENTIONAL SPINE CENTER - Specialty Care185 Queen City AvenueManchesterNHActive
RRC300012-28ChildRRCELLIOT HOSPITALBEDFORD- ELLIOT ENDOCRINOLOGY ASSOCIATES - Specialty Care25 Leavy DriveBedfordNHActive
RRC300012-29ChildRRCELLIOT HOSPITALELLIOT INTERNAL MEDICINE- LONDONDERRY - Internal Medicine40 Buttrick RoadLondonderryNHActive
RRC300012-30ChildRRCELLIOT HOSPITALELLIOT FAMILY MEDICINE- WINDHAM - Family Medicine5 Industrial Drive, Unit BWindhamNHActive
RRC300012-31ChildRRCELLIOT HOSPITALELLIOT PRIMARY CARE- BRIARWOOD - Primary Care445 Cypress Street, Suite 5ManchesterNHActive
RRC300012-32ChildRRCELLIOT HOSPITALELLIOT FAMILY HEALTH CENTER- SUNCOOK - Family Medicine50 Pinewood RoadAllenstownNHActive
RRC300012-33ChildRRCELLIOT HOSPITALELLIOT FAMILY MEDICINE- MANCHESTER - Family Medicine130 Tarrytown RoadManchesterNHActive
RRC300012-34ChildRRCELLIOT HOSPITALELLIOT FAMILY MEDICINE- HOOKSETT - Family Medicine20 Chambers Drive, Suite 1200HooksettNHActive
RRC300012-35ChildRRCELLIOT HOSPITALELLIOT INTERNAL MEDICINE- BEDFORD - Family Medicine25 Leavy DriveManchesterNHActive
RRC300012-36ChildRRCELLIOT HOSPITALELLIOT FAMILY MEDICINE- BEDFORD - Family Medicine25 Leavy DriveBedfordNHActive
RRC300012-37ChildRRCELLIOT HOSPITALELLIOT PRIMARY CARE - RAYMOND - Primary Care15 Freetown Road, Ste 8RaymondNHActive
RRC300012-38ChildRRCELLIOT HOSPITALELLIOT PRIMARY CARE- LONDONDERRY - Primary Care40 Buttrick RoadLondonderryNHActive
RRC300012-39ChildRRCELLIOT HOSPITALBEDFORD- DIABETES MANAGEMENT - Diabetes Counseling25 Leavy DriveBedfordNHActive
RRC300012-40ChildRRCELLIOT HOSPITALDERRYFIELD MEDICAL GROUP - Primary Care275 MAMMOTH RDMANCHESTERNHActive
RRC300012-41ChildRRCELLIOT HOSPITALELLIOT MEDICATION CLINIC- SUNCOOK - Coumadin Clinic50 Pinewood RoadAllenstownNHActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsStateUpdate ApprovedActive10/1/2024 12:01 AM
ContactsSigned ByInsertHospital Type Change Request Curti, Joseph Tate COO Elliot Hospital 60366320828/28/2024 6:36 AM
Details340B IDUpdateHospital Type Change Request RRC300012-008/28/2024 6:36 AM
DatesParticipating Approval DateUpdateHospital Type Change Request 8/28/2024 6:36:58 AM8/28/2024 6:36 AM
DetailsStateUpdateHospital Type Change RequestPendingApproved8/28/2024 6:36 AM
DatesSigned By DateUpdateHospital Type Change Request 8/26/2024 8:36:51 AM8/28/2024 6:36 AM
DatesStart DateUpdateHospital Type Change Request 10/1/2024 12:00:00 AM8/28/2024 6:36 AM
AddressesMain AddressInsertHospital Type Change Request  1 ELLIOT WAY MANCHESTER, NH 031037/12/2024 10:01 AM
AddressesShipping AddressInsertHospital Type Change Request Elliot Hospital 1 Elliot Way Manchester, NH 031037/12/2024 10:01 AM
AddressesShipping AddressInsertHospital Type Change Request Elliot Pharmacy at River's Edge 175 Queen City Avenue Suite 1 Manchester, NH 031017/12/2024 10:01 AM
AddressesShipping AddressInsertHospital Type Change Request Elliot Hospital Pharm 1 Elliot Way Manchester, NH 031037/12/2024 10:01 AM
AddressesShipping AddressInsertHospital Type Change Request Elliot Pharmacy at Bedford 25 Leavy Drive Bedford, NH 031107/12/2024 10:01 AM
AddressesShipping AddressInsertHospital Type Change Request Safecor Health, LLC 317 New Boston Street Suite 100 Woburn, MA 018017/12/2024 10:01 AM
ContactsPrimary ContactInsertHospital Type Change Request Andrade, Michelle Marie 340B Program Manager Elliot Hospital 60366324307/12/2024 10:01 AM
ContactsAuthorizing OfficialInsertHospital Type Change Request Curti, Joseph Tate COO Elliot Hospital 60366320827/12/2024 10:01 AM
DetailsAssistance Received From DateInsertHospital Type Change Request  7/12/2024 10:01 AM
DetailsAssistance Received To DateInsertHospital Type Change Request  7/12/2024 10:01 AM
DetailsLast Recertification DateInsertHospital Type Change Request  7/12/2024 10:01 AM
DetailsGrant NumberInsertHospital Type Change Request  7/12/2024 10:01 AM
Details340B IDInsertHospital Type Change Request  7/12/2024 10:01 AM
DetailsIs Authorizing Official EHB DataInsertHospital Type Change Request  7/12/2024 10:01 AM
DatesLast Date That 340B Drugs PurchasedInsertHospital Type Change Request  7/12/2024 10:01 AM
DetailsMedicare Provider NumberInsertHospital Type Change Request 3000127/12/2024 10:01 AM
DetailsEntity NameInsertHospital Type Change Request ELLIOT HOSPITAL7/12/2024 10:01 AM
DetailsNOFO NumberInsertHospital Type Change Request  7/12/2024 10:01 AM
DetailsProgram CodeInsertHospital Type Change Request RRC7/12/2024 10:01 AM
DetailsEntity SubnameInsertHospital Type Change Request  7/12/2024 10:01 AM
DatesParticipating Approval DateInsertHospital Type Change Request  7/12/2024 10:01 AM
DetailsStateInsertHospital Type Change Request Pending7/12/2024 10:01 AM
DatesRegistration DateInsertHospital Type Change Request 7/12/2024 10:01:09 AM7/12/2024 10:01 AM
DatesSigned By DateInsertHospital Type Change Request  7/12/2024 10:01 AM
DatesStart DateInsertHospital Type Change Request  7/12/2024 10:01 AM
TerminationsTermination CommentsInsertHospital Type Change Request  7/12/2024 10:01 AM
TerminationsTermination DateInsertHospital Type Change Request  7/12/2024 10:01 AM
TerminationsTermination Effective DateInsertHospital Type Change Request  7/12/2024 10:01 AM
TerminationsTermination ReasonInsertHospital Type Change Request  7/12/2024 10:01 AM