Covered Entity Details

CAH301308-02 VALLEY REGIONAL HOSPITAL (Active) - information as of 4/29/2025 2:52:27 AM

Main Details

Name

VALLEY REGIONAL HOSPITAL

Subdivision Name

Valley Regional Orthopaedics

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH301308-02

Medicare Provider Number

301308

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

10/9/2014

Participating Start Date

1/1/2015

Participating Approval Date

12/5/2014

Last Recertification Date

9/3/2024

Contacts

Authorizing Official

Mt Ascutney Hospital and Health Center
Celeste Pitts, CFO
(603) 542-3421

Primary Contact

Dartmouth-Hitchcock
Kristin A Chupka, Director - Pharmacy System 340B Program
(603) 656-0945

Addresses

Street Address

241A Elm Street
Claremont, NH 03743

Billing Address

Valley Regional Hospital
243 Elm Street
Claremont, NH 03743

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

Shipping Address 1

Valley Regional Hospital
243 Elm Street
Claremont, NH 03743

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
CAH301308-01	Child	CAH	VALLEY REGIONAL HOSPITAL	Associates In Medicine / Primary Care	241 Elm Street	Claremont	NH	Active
CAH301308-02	Child	CAH	VALLEY REGIONAL HOSPITAL	Valley Regional Orthopaedics	241A Elm Street	Claremont	NH	Active
CAH301308-04	Child	CAH	VALLEY REGIONAL HOSPITAL	Valley Primary Care	5 Dunning Street	Claremont	NH	Active
CAH301308-05	Child	CAH	VALLEY REGIONAL HOSPITAL	Valley Regional Urology	5 Dunning St	Claremont	NH	Terminated
CAH301308-06	Child	CAH	VALLEY REGIONAL HOSPITAL	Valley Family Physicians	5 DUNNING ST	CLAREMONT	NH	Terminated
CAH301308-07	Child	CAH	VALLEY REGIONAL HOSPITAL	VALLEY REGIONAL HOSPITAL INC - Valley Primary Care - Rafter and Metzger	7 DUNNING ST	CLAREMONT	NH	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Change Request	Caple, Jocelyn Chief Executive Officer Valley Regional Hospital 6035423454	Pitts, Celeste CFO Mt Ascutney Hospital and Health Center 6035423421	12/4/2024 7:36 AM
Contacts	Primary Contact	Update	Recertification	Walsh, Joseph 340B Analyst Valley Regional Hospital 6035421805	Chupka, Kristin A Director - Pharmacy System 340B Program Dartmouth-Hitchcock 6036560945	9/3/2024 8:14 AM
Details	Last Recertification Date	Update	Recertification	9/1/2023 8:52:25 AM	9/3/2024 8:14:57 AM	9/3/2024 8:14 AM
Contacts	Authorizing Official	Update	Change Request	Shaw, Jean CHIEF FINANCIAL OFFICER Valley Regional Hospital 6035423421	Caple, Jocelyn Chief Executive Officer Valley Regional Hospital 6035423454	10/5/2023 10:03 AM
Details	Last Recertification Date	Update	Recertification	8/31/2022 10:57:33 AM	9/1/2023 8:52:25 AM	9/1/2023 8:52 AM
Contacts	Primary Contact	Update	Change Request	Sindelar, Reid Logan Pharmacy Director Valley Regional Hospital 6035421805	Walsh, Joseph 340B Analyst Valley Regional Hospital 6035421805	6/5/2023 10:03 AM
Contacts	Primary Contact	Update	Change Request	Caple, Jocelyn Chief Executive Officer Valley Regional Hospital 6035423454	Sindelar, Reid Logan Pharmacy Director Valley Regional Hospital 6035421805	2/13/2023 11:33 AM
Details	Last Recertification Date	Update	Recertification	8/26/2021 3:11:06 PM	8/31/2022 10:57:33 AM	8/31/2022 10:57 AM
Details	Last Recertification Date	Update	Recertification	8/27/2020 2:21:50 PM	8/26/2021 3:11:06 PM	8/26/2021 3:11 PM
Contacts	Primary Contact	Update	Group Change Request	Drye, Melissa Director of Pharmacy Valley Regional Hospital 6035421805	Caple, Jocelyn Chief Executive Officer Valley Regional Hospital 6035423454	7/26/2021 6:49 AM
Details	Last Recertification Date	Update	Recertification	9/5/2019 2:42:50 PM	8/27/2020 2:21:50 PM	8/27/2020 2:21 PM
Details	Last Recertification Date	Update	Recertification	8/21/2018 2:52:29 PM	9/5/2019 2:42:50 PM	9/5/2019 2:42 PM
Contacts	Authorizing Official	Update	Change Request	Wright, Peter CHIEF Executive OFFICER Valley Regional Hospital 6035423400	Shaw, Jean CHIEF FINANCIAL OFFICER Valley Regional Hospital 6035423421	1/22/2019 1:52 PM
Contacts	Primary Contact	Update	Change Request	Shaw, Jean CHIEF FINANCIAL OFFICER Valley Regional Hospital 6035423421	Drye, Melissa Director of Pharmacy Valley Regional Hospital 6035421805	1/21/2019 11:12 AM
Addresses	Billing Address	Insert	Change Request		Valley Regional Hospital 243 Elm Street Claremont, NH 03743	12/6/2018 10:04 AM
Addresses	Shipping Address	Insert	Change Request		Valley Regional Hospital 243 Elm Street Claremont, NH 03743	12/6/2018 10:04 AM
Details	Last Recertification Date	Update	Recertification	11/6/2017 3:18:32 PM	8/21/2018 2:52:29 PM	8/21/2018 2:52 PM
Details	Last Recertification Date	Update	Recertification	9/6/2016 12:00:00 AM	11/6/2017 3:18:32 PM	11/6/2017 3:18 PM
Contacts	Primary Contact	Update		Shaw, Jean CHIEF FINANCIAL OFFICER 6035423421	Shaw, Jean CHIEF FINANCIAL OFFICER Valley Regional Hospital 6035423421	10/10/2017 3:11 PM
Contacts	Authorizing Official	Update		Wright, Peter CHIEF Executive OFFICER 6035423400	Wright, Peter CHIEF Executive OFFICER Valley Regional Hospital 6035423400	10/10/2017 2:35 PM
Contacts	Primary Contact	Insert			Shaw, Jean CHIEF FINANCIAL OFFICER 6035423421	4/19/2017 10:30 AM
Contacts	Authorizing Official	Insert			Wright, Peter CHIEF Executive OFFICER 6035423400	4/19/2017 10:30 AM
Contacts	Signed By	Insert			MONETTE, STEVEN CHIEF FINANCIAL OFFICER 6035421852	4/19/2017 10:30 AM
Addresses	Main Address	Insert			241A Elm Street Claremont, NH 03743	4/19/2017 10:30 AM
Details	Last Recertification Date	Update		9/4/2015 12:00:00 AM	9/6/2016 12:00:00 AM	9/6/2016 2:16 PM
Details	Last Recertification Date	Update			9/4/2015 12:00:00 AM	9/4/2015 3:41 PM
Dates	Participating Approval Date	Update			12/5/2014 12:00:00 AM	12/5/2014 5:06 PM
Details	State	Update		Pending	Active	12/5/2014 5:06 PM
Dates	Start Date	Update			1/1/2015 12:00:00 AM	12/5/2014 5:06 PM
Details	Entity Subname	Update		Sleep Center in Bend	Valley Regional Orthopaedics	10/26/2014 10:20 PM
Details	Entity Subname	Update		Valley Regional Orthopaedics	Sleep Center in Bend	10/16/2014 10:51 AM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_46936	CAH301308-02	10/16/2014 10:50 AM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_46936	10/9/2014 2:27 PM
Details	Last Recertification Date	Insert				10/9/2014 2:27 PM
Details	Grant Number	Insert				10/9/2014 2:27 PM
Details	340B ID	Insert				10/9/2014 2:27 PM
Details	Is Authorizing Official EHB Data	Insert				10/9/2014 2:27 PM
Dates	Last Date That 340B Drugs Purchased	Insert				10/9/2014 2:27 PM
Details	Medicare Provider Number	Insert			301308	10/9/2014 2:27 PM
Details	Entity Name	Insert			VALLEY REGIONAL HOSPITAL	10/9/2014 2:27 PM
Details	Program Code	Insert			CAH	10/9/2014 2:27 PM
Details	Entity Subname	Insert			Valley Regional Orthopaedics	10/9/2014 2:27 PM
Dates	Participating Approval Date	Insert				10/9/2014 2:27 PM
Details	State	Insert			Pending	10/9/2014 2:27 PM
Dates	Registration Date	Insert			10/9/2014 12:00:00 AM	10/9/2014 2:27 PM
Dates	Signed By Date	Insert			10/9/2014 12:00:00 AM	10/9/2014 2:27 PM
Dates	Start Date	Insert				10/9/2014 2:27 PM
Terminations	Termination Comments	Insert				10/9/2014 2:27 PM
Terminations	Termination Date	Insert				10/9/2014 2:27 PM
Terminations	Termination Effective Date	Insert				10/9/2014 2:27 PM
Terminations	Termination Reason	Insert				10/9/2014 2:27 PM