Covered Entity Details

CAH301309-11 MONADNOCK COMMUNITY HOSPITAL (Active) - information as of 5/5/2025 11:56:12 PM

Main Details

Name

MONADNOCK COMMUNITY HOSPITAL

Subdivision Name

Monadnock Regional Pediatrics

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH301309-11

Medicare Provider Number

301309

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

5/23/2012

Participating Start Date

7/1/2012

Participating Approval Date

6/20/2012

Last Recertification Date

9/8/2024

Contacts

Authorizing Official

Monadnock Community Hospital
Richard Scheinblum, CFO
(603) 924-4699 Ext: 1738

Primary Contact

Monandock Community Hospital
Rochelle Sokol, Controller
(603) 924-1739

Addresses

Street Address

454 Old Street Road
Suite 106
Peterborough, NH 03458

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
CAH301309-01	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Rivermead	150 Rivermead Road	Peterborough	NH	Terminated
CAH301309-02	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Rindge Family Practice	145 US Rte 202	Rindge	NH	Active
CAH301309-03	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Orthopaedics	458 Old Street Road	Peterborough	NH	Active
CAH301309-04	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Anticoag Clinic	454 Old Street Road	Peterborough	NH	Active
CAH301309-05	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Neurology	454 Old Street Road	Peterborough	NH	Terminated
CAH301309-06	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Diabetes	458 Old Street Road	Peterborough	NH	Active
CAH301309-07	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Monadnock Family Care	454 Old Street Road	Peterborough	NH	Active
CAH301309-08	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	New Ipswich Family Medicine	821 Turnpike Road	New Ipswich	NH	Active
CAH301309-09	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Monadnock Internists	454 Old Street Road	Peterborough	NH	Terminated
CAH301309-10	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Monadnock Surgical Associates	454 Old Street Road	Peterborough	NH	Active
CAH301309-11	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Monadnock Regional Pediatrics	454 Old Street Road	Peterborough	NH	Active
CAH301309-12	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Monadnock Behavioral Health Services	458 Old Street Road	Peterborough	NH	Active
CAH301309-13	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Antrim Medical Group	12 Elm Street	Antrim	NH	Active
CAH301309-14	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Monadnock Internal Medicine	454 Old Street Road	Peterborough	NH	Active
CAH301309-15	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Jaffrey Family Medicine	82 Peterborough Street	Jaffrey	NH	Active
CAH301309-16	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Physical Therapy	458 Old Street Road	Peterborough	NH	Active
CAH301309-17	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Cardiac Rehab	458 Old Street Road	Peterborough	NH	Active
CAH301309-18	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Wound Care	454 Old Street Road	Peterborough	NH	Active
CAH301309-19	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Occupational Therapy	458 Old Street Road	Peterborough	NH	Active
CAH301309-20	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Speech Pathology	458 Old Street Road	Peterborough	NH	Active
CAH301309-21	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Jaffrey Physical Therapy	82 Peterborough Street	Jaffery	NH	Active
CAH301309-22	Child	CAH	MONADNOCK COMMUNITY HOSPITAL	Nutrition Services	458 Old Street Road	Peterborough	NH	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	9/10/2023 8:40:59 PM	9/8/2024 7:32:59 PM	9/8/2024 7:32 PM
Details	Last Recertification Date	Update	Recertification	9/15/2022 1:46:48 PM	9/10/2023 8:40:59 PM	9/10/2023 8:40 PM
Details	Last Recertification Date	Update	Recertification	8/27/2021 11:39:17 AM	9/15/2022 1:46:48 PM	9/15/2022 1:46 PM
Details	Last Recertification Date	Update	Recertification	8/18/2020 9:42:05 AM	8/27/2021 11:39:17 AM	8/27/2021 11:39 AM
Details	Last Recertification Date	Update	Recertification	9/3/2019 2:35:45 PM	8/18/2020 9:42:05 AM	8/18/2020 9:42 AM
Details	Last Recertification Date	Update	Recertification	8/28/2018 12:32:20 PM	9/3/2019 2:35:45 PM	9/3/2019 2:35 PM
Details	Last Recertification Date	Update	Recertification	11/7/2017 8:04:54 AM	8/28/2018 12:32:20 PM	8/28/2018 12:32 PM
Contacts	Primary Contact	Insert	Recertification		Sokol, Rochelle Controller Monandock Community Hospital 6039241739	11/7/2017 8:04 AM
Details	Last Recertification Date	Update	Recertification	8/29/2016 12:00:00 AM	11/7/2017 8:04:54 AM	11/7/2017 8:04 AM
Contacts	Authorizing Official	Update		Scheinblum, Richard CFO 6039244699-1738	Scheinblum, Richard CFO Monadnock Community Hospital 6039244699-1738	10/18/2017 9:17 AM
Contacts	Signed By	Update		Scheinblum, Richard CFO 6039244699-1738	Scheinblum, Richard CFO Monadnock Community Hospital 6039244699-1738	10/18/2017 9:17 AM
Contacts	Authorizing Official	Insert			Scheinblum, Richard CFO 6039244699-1738	7/24/2017 3:39 PM
Contacts	Signed By	Insert			Scheinblum, Richard CFO 6039244699-1738	7/24/2017 3:39 PM
Addresses	Main Address	Insert			454 Old Street Road Suite 106 Peterborough, NH 03458	6/5/2017 5:34 PM
Details	Last Recertification Date	Update		8/18/2015 12:00:00 AM	8/29/2016 12:00:00 AM	8/29/2016 10:43 AM
Details	Last Recertification Date	Update		9/10/2014 12:00:00 AM	8/18/2015 12:00:00 AM	8/28/2015 12:09 PM
Details	Last Recertification Date	Update		9/12/2013 12:00:00 AM	9/10/2014 12:00:00 AM	9/10/2014 6:52 AM
Details	Last Recertification Date	Update			9/12/2013 12:00:00 AM	9/12/2013 8:02 PM
Details	340B ID	Update		IS-CA-CAH301309-11	CAH301309-11	6/20/2012 12:04 PM
Dates	Participating Approval Date	Update			6/20/2012 12:00:00 AM	6/20/2012 12:04 PM
Details	State	Update		Pending	Active	6/20/2012 12:04 PM
Dates	Start Date	Update			7/1/2012 12:00:00 AM	6/20/2012 12:04 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG	IS-CA-CAH301309-11	6/11/2012 4:04 PM
Details	Last Recertification Date	Insert				5/23/2012 9:14 PM
Details	Grant Number	Insert				5/23/2012 9:14 PM
Details	340B ID	Insert			OUTPATIENT_ONLINE_REG	5/23/2012 9:14 PM
Details	Is Authorizing Official EHB Data	Insert				5/23/2012 9:14 PM
Dates	Last Date That 340B Drugs Purchased	Insert				5/23/2012 9:14 PM
Details	Medicare Provider Number	Insert			301309	5/23/2012 9:14 PM
Details	Entity Name	Insert			MONADNOCK COMMUNITY HOSPITAL	5/23/2012 9:14 PM
Details	Program Code	Insert			CAH	5/23/2012 9:14 PM
Details	Entity Subname	Insert			Monadnock Regional Pediatrics	5/23/2012 9:14 PM
Dates	Participating Approval Date	Insert				5/23/2012 9:14 PM
Details	State	Insert			Pending	5/23/2012 9:14 PM
Dates	Registration Date	Insert			5/23/2012 12:00:00 AM	5/23/2012 9:14 PM
Dates	Signed By Date	Insert			5/23/2012 12:00:00 AM	5/23/2012 9:14 PM
Dates	Start Date	Insert				5/23/2012 9:14 PM
Terminations	Termination Comments	Insert				5/23/2012 9:14 PM
Terminations	Termination Date	Insert				5/23/2012 9:14 PM
Terminations	Termination Effective Date	Insert				5/23/2012 9:14 PM
Terminations	Termination Reason	Insert				5/23/2012 9:14 PM