| Addresses | Billing Address | Update | Change Request | Northeastern Vermont Regional Hospital
PO Box 905
1315 Hospital Drive
St. Johnsbury, VT 05819 | Northeastern Vermont Regional Hospital
1315 Hospital Drive
St. Johnsbury, VT 05819 | 9/26/2024 3:41 PM |
| Details | Last Recertification Date | Update | Recertification | 8/17/2023 4:06:22 PM | 8/21/2024 9:21:14 AM | 8/21/2024 9:21 AM |
| Contacts | Signed By | Update | New Registration | Hersey, Robert
CFO
NVRH
8027487520 | Hersey, Robert
CFO
NVRH
8027487530 | 1/9/2024 8:34 AM |
| Contacts | Primary Contact | Update | Group Change Request | Schoolcraft, Terri
Controller
NVRH
8027487508 | Herold, Tracey L
340B Analyst
Northeastern Vermont Regional Hospital, Inc
8027487583 | 8/23/2023 7:10 AM |
| Details | Last Recertification Date | Update | Recertification | 9/6/2022 8:22:21 AM | 8/17/2023 4:06:22 PM | 8/17/2023 4:06 PM |
| Contacts | Authorizing Official | Update | AO Change Request | Hersey, Robert
CFO
NVRH
8027487520 | Bissonnette, Andre Leo
CFO
Northeastern Vermont Regional Hospital
8027487520 | 5/30/2023 10:05 AM |
| Details | Last Recertification Date | Update | Recertification | 8/23/2021 1:03:06 PM | 9/6/2022 8:22:21 AM | 9/6/2022 8:22 AM |
| Details | Last Recertification Date | Update | Recertification | 8/21/2020 4:06:55 PM | 8/23/2021 1:03:06 PM | 8/23/2021 1:03 PM |
| Details | Last Recertification Date | Update | Recertification | 8/28/2019 9:54:20 AM | 8/21/2020 4:06:55 PM | 8/21/2020 4:06 PM |
| Addresses | Billing Address | Insert | Recertification | | Northeastern Vermont Regional Hospital
PO Box 905
1315 Hospital Drive
St. Johnsbury, VT 05819 | 8/28/2019 9:54 AM |
| Addresses | Shipping Address | Insert | Recertification | | Northeastern Vermont Regional Hospital
1315 Hospital Drive
St. Johnsbury, VT 05819 | 8/28/2019 9:54 AM |
| Details | Last Recertification Date | Update | Recertification | 8/17/2018 9:56:10 AM | 8/28/2019 9:54:20 AM | 8/28/2019 9:54 AM |
| Details | Last Recertification Date | Update | Recertification | 11/6/2017 5:40:36 PM | 8/17/2018 9:56:10 AM | 8/17/2018 9:56 AM |
| Details | Last Recertification Date | Update | Recertification | 10/26/2017 12:11:02 PM | 11/6/2017 5:40:36 PM | 11/6/2017 5:40 PM |
| Contacts | Primary Contact | Update | Recertification | Hersey, Robert
CFO
8027487520 | Schoolcraft, Terri
Controller
NVRH
8027487508 | 10/26/2017 12:11 PM |
| Details | Last Recertification Date | Update | Recertification | 8/15/2016 12:00:00 AM | 10/26/2017 12:11:02 PM | 10/26/2017 12:11 PM |
| Contacts | Authorizing Official | Update | | Hersey, Robert
CFO
8027487520 | Hersey, Robert
CFO
NVRH
8027487520 | 10/26/2017 11:49 AM |
| Contacts | Signed By | Update | | Hersey, Robert
CFO
8027487520 | Hersey, Robert
CFO
NVRH
8027487520 | 10/26/2017 11:49 AM |
| Addresses | Main Address | Insert | | |
1290 Hospital Drive
St Johnsbury, VT 05819 | 8/15/2016 1:55 PM |
| Contacts | Authorizing Official | Insert | | | Hersey, Robert
CFO
8027487520 | 8/15/2016 1:55 PM |
| Contacts | Primary Contact | Insert | | | Hersey, Robert
CFO
8027487520 | 8/15/2016 1:55 PM |
| Contacts | Signed By | Insert | | | Hersey, Robert
CFO
8027487520 | 8/15/2016 1:55 PM |
| Details | Last Recertification Date | Update | | 8/12/2015 12:00:00 AM | 8/15/2016 12:00:00 AM | 8/15/2016 1:55 PM |
| Details | Last Recertification Date | Update | | 8/28/2014 12:00:00 AM | 8/12/2015 12:00:00 AM | 8/19/2015 5:33 PM |
| Details | Last Recertification Date | Update | | 8/22/2013 12:00:00 AM | 8/28/2014 12:00:00 AM | 8/28/2014 10:54 AM |
| Details | Last Recertification Date | Update | | 8/22/2013 10:55:42 AM | 8/22/2013 12:00:00 AM | 8/29/2013 10:24 AM |
| Details | Last Recertification Date | Update | | | 8/22/2013 10:55:42 AM | 8/22/2013 10:55 AM |
| Details | 340B ID | Update | | IS-DM-CAH471303-05 | CAH471303-05 | 6/19/2012 11:40 AM |
| Dates | Participating Approval Date | Update | | | 6/19/2012 12:00:00 AM | 6/19/2012 11:40 AM |
| Details | State | Update | | Pending | Active | 6/19/2012 11:40 AM |
| Dates | Start Date | Update | | | 7/1/2012 12:00:00 AM | 6/19/2012 11:40 AM |
| Details | 340B ID | Update | | OUTPATIENT_ONLINE_REG | IS-DM-CAH471303-05 | 5/22/2012 2:40 PM |
| Details | Last Recertification Date | Insert | | | | 5/10/2012 6:12 PM |
| Details | Grant Number | Insert | | | | 5/10/2012 6:12 PM |
| Details | 340B ID | Insert | | | OUTPATIENT_ONLINE_REG | 5/10/2012 6:12 PM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 5/10/2012 6:12 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 5/10/2012 6:12 PM |
| Details | Medicare Provider Number | Insert | | | 471303 | 5/10/2012 6:12 PM |
| Details | Entity Name | Insert | | | NORTHEASTERN VERMONT REGIONAL HOSPITAL | 5/10/2012 6:12 PM |
| Details | Program Code | Insert | | | CAH | 5/10/2012 6:12 PM |
| Details | Entity Subname | Insert | | | NVRH-Neurology Group | 5/10/2012 6:12 PM |
| Dates | Participating Approval Date | Insert | | | | 5/10/2012 6:12 PM |
| Details | State | Insert | | | Pending | 5/10/2012 6:12 PM |
| Dates | Registration Date | Insert | | | 5/10/2012 12:00:00 AM | 5/10/2012 6:12 PM |
| Dates | Signed By Date | Insert | | | 5/10/2012 12:00:00 AM | 5/10/2012 6:12 PM |
| Dates | Start Date | Insert | | | | 5/10/2012 6:12 PM |
| Terminations | Termination Comments | Insert | | | | 5/10/2012 6:12 PM |
| Terminations | Termination Date | Insert | | | | 5/10/2012 6:12 PM |
| Terminations | Termination Effective Date | Insert | | | | 5/10/2012 6:12 PM |
| Terminations | Termination Reason | Insert | | | | 5/10/2012 6:12 PM |