Covered Entity Details

CH01015F COMMUNITY HEALTH CENTERS OF BURLINGTON, INC. (Active) - information as of 5/5/2025 12:04:14 AM

Main Details

Name

COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.

Subdivision Name

GoodHealth

Type

HRSA-Funded Health Center

Site ID

BPS-H80-017688

340B ID

CH01015F

Grant Number

H80CS00311

Additional Details

Current Program Status

Active

Registration Date

7/12/2016

Participating Start Date

10/1/2016

Participating Approval Date

7/15/2016

Last Recertification Date

2/10/2025

Contacts

Authorizing Official

Community Health Centers of Burlington
Jeffrey McKee, CEO
(802) 264-8190

Primary Contact

Community Health Centers of Burlington
Amy Whitehouse, Population Health Analyst
(802) 264-8158

Addresses

Street Address

368 Dorset Street #1
South Burlington, VT 05403

Billing Address

Community Health Centers of Burlington, Inc.
617 Riverside Avenue
Burlington, VT 05401

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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	Last Updated On
Contract Detail	COMMUNITY HEALTH CENTERS OF BURLINGTON,	DBA: COMMUNITY HEALTH CENTERS- PHARMACY	617 RIVERSIDE AVE STE 1	BURLINGTON	VT	05401	04/15/2025	07/01/2025	04/15/2025
Contract Detail	COMMUNITY HEALTH PHARMACY	158 BRENTWOOD DR STE 6		COLCHESTER	VT	05446-7994	04/11/2025	07/01/2025	04/11/2025
Contract Detail	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	04/11/2025	07/01/2025	04/11/2025
Contract Detail	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #35	3 CENTRE DRIVE	MILTON	VT	05468	04/08/2025	07/01/2025	04/08/2025
Contract Detail	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #21	82 PEARL STREET	ESSEX JUNCTION	VT	05452	04/08/2025	07/01/2025	04/08/2025
Contract Detail	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #29	308 SHELBURNE ROAD	BURLINGTON	VT	05401	04/10/2025	07/01/2025	04/10/2025
Contract Detail	KPH HEALTHCARE SERVICES, INC.	DBA: KINNEY DRUGS CF	471 E MAIN ST UNIT 5	GOUVERNEUR	NY	13642	04/10/2025	07/01/2025	04/10/2025
Contract Detail	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD FOOD & DRUG #8161	1127 NORTH AVENUE SUITE 11	BURLINGTON	VT	05408	04/08/2025	07/01/2025	04/08/2025
Contract Detail	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	217 DORSET STREET, UNIVERSITY MALL	SOUTH BURLINGTON	VT	05403	04/10/2025	07/01/2025	04/10/2025
Contract Detail	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	21-A ESSEX WAY	ESSEX JUNCTION	VT	05452	04/10/2025	07/01/2025	04/10/2025
Contract Detail	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #84	935 SHELBURNE ROAD	SOUTH BURLINGTON	VT	05403	04/10/2025	07/01/2025	04/10/2025
Contract Detail	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	78 MARSHALL AVE	WILLISTON	VT	05495	04/10/2025	07/01/2025	04/10/2025
Contract Detail	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #2518	71 BOXWOOD ST	WILLISTON	VT	05495	04/08/2025	07/01/2025	04/08/2025
Contract Detail	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0615	66 MOUNTAIN VIEW DR	COLCHESTER	VT	05446	04/10/2025	07/01/2025	04/10/2025
Contract Detail	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0117	570 SHELBURNE RD	BURLINGTON	VT	05401	04/10/2025	07/01/2025	04/10/2025
Contract Detail	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #11037	35 CHURCH ST	BURLINGTON	VT	05401	04/08/2025	07/01/2025	04/08/2025
Contract Detail	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 7103	49 WRIGHT AVE	WILLISTON	VT	05495-4419	04/08/2025	07/01/2025	04/08/2025
Contract Detail	VERMONT CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01052	7 ESSEX WAY	ESSEX	VT	05452	04/10/2025	07/01/2025	04/10/2025
Contract Detail	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10216	69 MOUNTIAN VIEW DRIVE	COLCHESTER	VT	05446-5919	04/10/2025	07/01/2025	04/10/2025
Contract Detail	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #10690	1 DORSET STREET	SOUTH BURLINGTON	VT	05403	04/10/2025	07/01/2025	04/10/2025
Contract Detail	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/08/2025	07/01/2025	04/08/2025
Contract Detail	WAL-MART PHARMACY 10-2224	863 HARVEST LANE		WILLISTON	VT	05495	04/10/2025	07/01/2025	04/10/2025
Contract Detail	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/08/2025	07/01/2025	04/08/2025
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17485	321 MAIN ST STE B	WINOOSKI	VT	05404	04/08/2025	07/01/2025	04/08/2025
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17471	9 SUSIE WILSON RD	ESSEX JUNCTION	VT	05452	04/08/2025	07/01/2025	04/08/2025
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #19570	1024 NORTH AVE	BURLINGTON	VT	05408	04/08/2025	07/01/2025	04/08/2025
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17747	201 US ROUTE 7 SOUTH	MILTON	VT	05468	04/08/2025	07/01/2025	04/08/2025
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #19795	133 N MAIN ST SUITE 23	SAINT ALBANS	VT	05478-1735	04/10/2025	07/01/2025	04/10/2025
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #18325	30 SHELBURNE SHOPPING PARK	SHELBURNE	VT	05482	04/10/2025	07/01/2025	04/10/2025
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17447	39 HINESBURG RD	SOUTH BURLINGTON	VT	05403	04/10/2025	07/01/2025	04/10/2025
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17183	1184 PRIM RD SUITE 2	COLCHESTER	VT	05446	04/10/2025	07/01/2025	04/10/2025
Contract Detail	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	04/10/2025	07/01/2025	04/10/2025
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	04/11/2025	07/01/2025	04/11/2025
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	04/11/2025	07/01/2025	04/11/2025
Contract Detail	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	04/11/2025	07/01/2025	04/11/2025
Contract Detail	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/10/2025	07/01/2025	04/10/2025

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH010150	Active	BPS-H80-011088	COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.	Riverside Health Center	617 Riverside Ave	Burlington	VT
CH01015A	Active	BPS-H80-006190	COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.	Pearl Street Youth Health Center	179 PEARL ST	BURLINGTON	VT
CH01015C	Active	BPS-H80-004299	COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.	Safe Harbor Health Center	184 S WINOOSKI AVE	BURLINGTON	VT
CH01015D	Active	BPS-H80-018699	COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.	Champlain Islands Health Center	52 Community Lane	South Hero	VT
CH01015E	Active	BPS-H80-017252	COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.	South End Health Center	789 Pine St	Burlington	VT
CH01015F	Active	BPS-H80-017688	COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.	GoodHealth	368 Dorset Street #1	South Burlington	VT
CH01015G	Active	BPS-H80-018814	COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.	Winooski Family Health	32 Malletts Bay Avenue	Winooski	VT
CH01015H	Active	BPS-H80-033800	COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.	Community Health Centers at Essex	87 Main St	Essex Junction	VT

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH01015A	COMMUNITY HEALTH CENTERS OF BURLINGTON,	DBA: COMMUNITY HEALTH CENTERS- PHARMACY	617 RIVERSIDE AVE STE 1	BURLINGTON	VT	05401	07/01/2025
CH01015E	COMMUNITY HEALTH CENTERS OF BURLINGTON,	DBA: COMMUNITY HEALTH CENTERS- PHARMACY	617 RIVERSIDE AVE STE 1	BURLINGTON	VT	05401	07/01/2025
CH01015C	COMMUNITY HEALTH CENTERS OF BURLINGTON,	DBA: COMMUNITY HEALTH CENTERS- PHARMACY	617 RIVERSIDE AVE STE 1	BURLINGTON	VT	05401	07/01/2025
CH01015D	COMMUNITY HEALTH CENTERS OF BURLINGTON,	DBA: COMMUNITY HEALTH CENTERS- PHARMACY	617 RIVERSIDE AVE STE 1	BURLINGTON	VT	05401	07/01/2025
CH01015H	COMMUNITY HEALTH CENTERS OF BURLINGTON,	DBA: COMMUNITY HEALTH CENTERS- PHARMACY	617 RIVERSIDE AVE STE 1	BURLINGTON	VT	05401	07/01/2025
CH01015F	COMMUNITY HEALTH CENTERS OF BURLINGTON,	DBA: COMMUNITY HEALTH CENTERS- PHARMACY	617 RIVERSIDE AVE STE 1	BURLINGTON	VT	05401	07/01/2025
CH01015G	COMMUNITY HEALTH CENTERS OF BURLINGTON,	DBA: COMMUNITY HEALTH CENTERS- PHARMACY	617 RIVERSIDE AVE STE 1	BURLINGTON	VT	05401	07/01/2025
CH010150	COMMUNITY HEALTH PHARMACY	158 BRENTWOOD DR STE 6		COLCHESTER	VT	05446-7994	10/15/2008
CH01015C	COMMUNITY HEALTH PHARMACY	158 BRENTWOOD DR STE 6		COLCHESTER	VT	05446-7994	10/15/2008
CH01015A	COMMUNITY HEALTH PHARMACY	158 BRENTWOOD DR STE 6		COLCHESTER	VT	05446-7994	10/15/2008
CH01015G	COMMUNITY HEALTH PHARMACY	158 BRENTWOOD DR STE 6		COLCHESTER	VT	05446-7994	07/01/2025
CH01015E	COMMUNITY HEALTH PHARMACY	158 BRENTWOOD DR STE 6		COLCHESTER	VT	05446-7994	07/01/2025
CH01015F	COMMUNITY HEALTH PHARMACY	158 BRENTWOOD DR STE 6		COLCHESTER	VT	05446-7994	07/01/2025
CH01015D	COMMUNITY HEALTH PHARMACY	158 BRENTWOOD DR STE 6		COLCHESTER	VT	05446-7994	07/01/2025
CH01015H	COMMUNITY HEALTH PHARMACY	158 BRENTWOOD DR STE 6		COLCHESTER	VT	05446-7994	07/01/2025
CH01015A	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2025
CH01015E	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2025
CH010150	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2025
CH01015D	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2025
CH01015C	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2025
CH01015F	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2025
CH01015H	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2025
CH01015G	CYSTIC FIBROSIS SERVICES, LLC	DBA WALGREENS SPECIALTY PHARMACY #16280	10530 JOHN W ELLIOTT DR STE 200	FRISCO	TX	75033	07/01/2025
CH010150	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #35	3 CENTRE DRIVE	MILTON	VT	05468	04/01/2022
CH010150	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #21	82 PEARL STREET	ESSEX JUNCTION	VT	05452	04/01/2022
CH010150	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #29	308 SHELBURNE ROAD	BURLINGTON	VT	05401	04/01/2022
CH010150	KPH HEALTHCARE SERVICES, INC.	DBA: KINNEY DRUGS CF	471 E MAIN ST UNIT 5	GOUVERNEUR	NY	13642	01/01/2025
CH01015D	KPH HEALTHCARE SERVICES, INC.	DBA: KINNEY DRUGS CF	471 E MAIN ST UNIT 5	GOUVERNEUR	NY	13642	07/01/2025
CH01015G	KPH HEALTHCARE SERVICES, INC.	DBA: KINNEY DRUGS CF	471 E MAIN ST UNIT 5	GOUVERNEUR	NY	13642	07/01/2025
CH01015F	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #35	3 CENTRE DRIVE	MILTON	VT	05468	07/01/2025
CH01015C	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #35	3 CENTRE DRIVE	MILTON	VT	05468	07/01/2025
CH01015A	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #21	82 PEARL STREET	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015D	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #29	308 SHELBURNE ROAD	BURLINGTON	VT	05401	07/01/2025
CH01015H	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #35	3 CENTRE DRIVE	MILTON	VT	05468	07/01/2025
CH01015A	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #35	3 CENTRE DRIVE	MILTON	VT	05468	07/01/2025
CH01015D	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #21	82 PEARL STREET	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015H	KPH HEALTHCARE SERVICES, INC.	DBA: KINNEY DRUGS CF	471 E MAIN ST UNIT 5	GOUVERNEUR	NY	13642	07/01/2025
CH01015G	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #35	3 CENTRE DRIVE	MILTON	VT	05468	07/01/2025
CH01015C	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #21	82 PEARL STREET	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015G	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #21	82 PEARL STREET	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015E	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #29	308 SHELBURNE ROAD	BURLINGTON	VT	05401	07/01/2025
CH01015F	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #21	82 PEARL STREET	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015F	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #29	308 SHELBURNE ROAD	BURLINGTON	VT	05401	07/01/2025
CH01015E	KPH HEALTHCARE SERVICES, INC.	DBA: KINNEY DRUGS CF	471 E MAIN ST UNIT 5	GOUVERNEUR	NY	13642	07/01/2025
CH01015C	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #29	308 SHELBURNE ROAD	BURLINGTON	VT	05401	07/01/2025
CH01015F	KPH HEALTHCARE SERVICES, INC.	DBA: KINNEY DRUGS CF	471 E MAIN ST UNIT 5	GOUVERNEUR	NY	13642	07/01/2025
CH01015E	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #35	3 CENTRE DRIVE	MILTON	VT	05468	07/01/2025
CH01015H	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #29	308 SHELBURNE ROAD	BURLINGTON	VT	05401	07/01/2025
CH01015A	KPH HEALTHCARE SERVICES, INC.	DBA: KINNEY DRUGS CF	471 E MAIN ST UNIT 5	GOUVERNEUR	NY	13642	07/01/2025
CH01015E	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #21	82 PEARL STREET	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015D	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #35	3 CENTRE DRIVE	MILTON	VT	05468	07/01/2025
CH01015C	KPH HEALTHCARE SERVICES, INC.	DBA: KINNEY DRUGS CF	471 E MAIN ST UNIT 5	GOUVERNEUR	NY	13642	07/01/2025
CH01015A	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #29	308 SHELBURNE ROAD	BURLINGTON	VT	05401	07/01/2025
CH01015H	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #21	82 PEARL STREET	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015G	KPH HEALTHCARE SERVICES, INC.	KINNEY DRUGS #29	308 SHELBURNE ROAD	BURLINGTON	VT	05401	07/01/2025
CH010150	LAKESIDE PHARMACY INC	242 PEARL ST		BURLINGTON	VT	05401	08/17/2012	10/08/2018
CH010150	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #84	935 SHELBURNE ROAD	SOUTH BURLINGTON	VT	05403	04/01/2021
CH010150	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	21-A ESSEX WAY	ESSEX JUNCTION	VT	05452	04/01/2021
CH010150	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD FOOD & DRUG #8161	1127 NORTH AVENUE SUITE 11	BURLINGTON	VT	05408	04/01/2021
CH010150	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	217 DORSET STREET, UNIVERSITY MALL	SOUTH BURLINGTON	VT	05403	04/01/2021
CH010150	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	78 MARSHALL AVE	WILLISTON	VT	05495	04/01/2021
CH01015A	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	78 MARSHALL AVE	WILLISTON	VT	05495	07/01/2025
CH01015G	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #84	935 SHELBURNE ROAD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015E	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	21-A ESSEX WAY	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015F	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD FOOD & DRUG #8161	1127 NORTH AVENUE SUITE 11	BURLINGTON	VT	05408	07/01/2025
CH01015G	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	78 MARSHALL AVE	WILLISTON	VT	05495	07/01/2025
CH01015A	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD FOOD & DRUG #8161	1127 NORTH AVENUE SUITE 11	BURLINGTON	VT	05408	07/01/2025
CH01015G	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	21-A ESSEX WAY	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015G	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	217 DORSET STREET, UNIVERSITY MALL	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015D	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #84	935 SHELBURNE ROAD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015G	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD FOOD & DRUG #8161	1127 NORTH AVENUE SUITE 11	BURLINGTON	VT	05408	07/01/2025
CH01015E	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD FOOD & DRUG #8161	1127 NORTH AVENUE SUITE 11	BURLINGTON	VT	05408	07/01/2025
CH01015C	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	78 MARSHALL AVE	WILLISTON	VT	05495	07/01/2025
CH01015E	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	217 DORSET STREET, UNIVERSITY MALL	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015H	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	217 DORSET STREET, UNIVERSITY MALL	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015A	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	217 DORSET STREET, UNIVERSITY MALL	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015E	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #84	935 SHELBURNE ROAD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015C	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	217 DORSET STREET, UNIVERSITY MALL	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015D	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	217 DORSET STREET, UNIVERSITY MALL	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015F	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	217 DORSET STREET, UNIVERSITY MALL	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015D	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	21-A ESSEX WAY	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015A	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #84	935 SHELBURNE ROAD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015F	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	21-A ESSEX WAY	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015H	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	78 MARSHALL AVE	WILLISTON	VT	05495	07/01/2025
CH01015D	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	78 MARSHALL AVE	WILLISTON	VT	05495	07/01/2025
CH01015D	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD FOOD & DRUG #8161	1127 NORTH AVENUE SUITE 11	BURLINGTON	VT	05408	07/01/2025
CH01015C	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	21-A ESSEX WAY	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015A	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	21-A ESSEX WAY	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015H	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	21-A ESSEX WAY	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015F	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #84	935 SHELBURNE ROAD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015C	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #84	935 SHELBURNE ROAD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015H	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD FOOD & DRUG #8161	1127 NORTH AVENUE SUITE 11	BURLINGTON	VT	05408	07/01/2025
CH01015H	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #84	935 SHELBURNE ROAD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015C	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD FOOD & DRUG #8161	1127 NORTH AVENUE SUITE 11	BURLINGTON	VT	05408	07/01/2025
CH01015F	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	78 MARSHALL AVE	WILLISTON	VT	05495	07/01/2025
CH01015E	MARTIN'S FOODS OF SOUTH BURLINGTON, LLC	DBA HANNAFORD SUPERMARKET & PHARMACY #83	78 MARSHALL AVE	WILLISTON	VT	05495	07/01/2025
CH010150	MAXI GREEN, INC.	RITE AID #10319	321 MAIN STREET	WINOOSKI	VT	05404	07/01/2013	01/30/2018
CH010150	MAXI GREEN, INC.	RITE AID #10321	1184 PRIM ROAD STE 2	COLCHESTER	VT	05446	07/01/2013	01/30/2018
CH010150	MAXI GREEN, INC.	RITE AID #10318	39 HINESBURG ROAD	SOUTH BURLINGTON	VT	05403	07/01/2013	01/30/2018
CH010150	MAXI GREEN, INC.	RITE AID #10317	158 CHERRY STREET	BURLINGTON	VT	05401	07/01/2013	01/30/2018
CH010150	RITE AID OF VERMONT, INC.	RITE AID #4272	1024 NORTH AVENUE	BURLINGTON	VT	05408	07/01/2013	01/30/2018
CH010150	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0615	66 MOUNTAIN VIEW DR	COLCHESTER	VT	05446	01/01/2020
CH010150	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #2518	71 BOXWOOD ST	WILLISTON	VT	05495	01/01/2020
CH010150	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0117	570 SHELBURNE RD	BURLINGTON	VT	05401	01/01/2020
CH01015D	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #2518	71 BOXWOOD ST	WILLISTON	VT	05495	07/01/2025
CH01015C	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #2518	71 BOXWOOD ST	WILLISTON	VT	05495	07/01/2025
CH01015C	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0117	570 SHELBURNE RD	BURLINGTON	VT	05401	07/01/2025
CH01015A	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #2518	71 BOXWOOD ST	WILLISTON	VT	05495	07/01/2025
CH01015G	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0117	570 SHELBURNE RD	BURLINGTON	VT	05401	07/01/2025
CH01015E	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0615	66 MOUNTAIN VIEW DR	COLCHESTER	VT	05446	07/01/2025
CH01015G	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #2518	71 BOXWOOD ST	WILLISTON	VT	05495	07/01/2025
CH01015H	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0117	570 SHELBURNE RD	BURLINGTON	VT	05401	07/01/2025
CH01015E	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0117	570 SHELBURNE RD	BURLINGTON	VT	05401	07/01/2025
CH01015A	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0615	66 MOUNTAIN VIEW DR	COLCHESTER	VT	05446	07/01/2025
CH01015F	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #2518	71 BOXWOOD ST	WILLISTON	VT	05495	07/01/2025
CH01015C	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0615	66 MOUNTAIN VIEW DR	COLCHESTER	VT	05446	07/01/2025
CH01015A	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0117	570 SHELBURNE RD	BURLINGTON	VT	05401	07/01/2025
CH01015H	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #2518	71 BOXWOOD ST	WILLISTON	VT	05495	07/01/2025
CH01015G	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0615	66 MOUNTAIN VIEW DR	COLCHESTER	VT	05446	07/01/2025
CH01015E	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #2518	71 BOXWOOD ST	WILLISTON	VT	05495	07/01/2025
CH01015D	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0117	570 SHELBURNE RD	BURLINGTON	VT	05401	07/01/2025
CH01015F	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0615	66 MOUNTAIN VIEW DR	COLCHESTER	VT	05446	07/01/2025
CH01015F	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0117	570 SHELBURNE RD	BURLINGTON	VT	05401	07/01/2025
CH01015H	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0615	66 MOUNTAIN VIEW DR	COLCHESTER	VT	05446	07/01/2025
CH01015D	SHAWS SUPERMARKETS INC	SHAWS PHARMACY #0615	66 MOUNTAIN VIEW DR	COLCHESTER	VT	05446	07/01/2025
CH010150	SOUTH HERO PHARMACY LLC	334 ROUTE 2		SOUTH HERO	VT	05486-4229	04/01/2015	06/26/2020
CH010150	VERMONT CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01052	7 ESSEX WAY	ESSEX	VT	05452	07/01/2019
CH010150	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #10690	1 DORSET STREET	SOUTH BURLINGTON	VT	05403	07/01/2019
CH010150	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10216	69 MOUNTIAN VIEW DRIVE	COLCHESTER	VT	05446-5919	07/01/2019
CH010150	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 7103	49 WRIGHT AVE	WILLISTON	VT	05495-4419	07/01/2019
CH010150	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #11037	35 CHURCH ST	BURLINGTON	VT	05401	07/01/2019
CH01015A	VERMONT CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01052	7 ESSEX WAY	ESSEX	VT	05452	07/01/2025
CH01015H	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 7103	49 WRIGHT AVE	WILLISTON	VT	05495-4419	07/01/2025
CH01015C	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #11037	35 CHURCH ST	BURLINGTON	VT	05401	07/01/2025
CH01015E	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10216	69 MOUNTIAN VIEW DRIVE	COLCHESTER	VT	05446-5919	07/01/2025
CH01015G	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #11037	35 CHURCH ST	BURLINGTON	VT	05401	07/01/2025
CH01015F	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #11037	35 CHURCH ST	BURLINGTON	VT	05401	07/01/2025
CH01015C	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10216	69 MOUNTIAN VIEW DRIVE	COLCHESTER	VT	05446-5919	07/01/2025
CH01015C	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 7103	49 WRIGHT AVE	WILLISTON	VT	05495-4419	07/01/2025
CH01015F	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 7103	49 WRIGHT AVE	WILLISTON	VT	05495-4419	07/01/2025
CH01015G	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10216	69 MOUNTIAN VIEW DRIVE	COLCHESTER	VT	05446-5919	07/01/2025
CH01015H	VERMONT CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01052	7 ESSEX WAY	ESSEX	VT	05452	07/01/2025
CH01015A	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #11037	35 CHURCH ST	BURLINGTON	VT	05401	07/01/2025
CH01015E	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #11037	35 CHURCH ST	BURLINGTON	VT	05401	07/01/2025
CH01015C	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #10690	1 DORSET STREET	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015D	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 7103	49 WRIGHT AVE	WILLISTON	VT	05495-4419	07/01/2025
CH01015A	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #10690	1 DORSET STREET	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015C	VERMONT CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01052	7 ESSEX WAY	ESSEX	VT	05452	07/01/2025
CH01015D	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10216	69 MOUNTIAN VIEW DRIVE	COLCHESTER	VT	05446-5919	07/01/2025
CH01015H	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #10690	1 DORSET STREET	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015H	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10216	69 MOUNTIAN VIEW DRIVE	COLCHESTER	VT	05446-5919	07/01/2025
CH01015E	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 7103	49 WRIGHT AVE	WILLISTON	VT	05495-4419	07/01/2025
CH01015F	VERMONT CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01052	7 ESSEX WAY	ESSEX	VT	05452	07/01/2025
CH01015G	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #10690	1 DORSET STREET	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015G	VERMONT CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01052	7 ESSEX WAY	ESSEX	VT	05452	07/01/2025
CH01015E	VERMONT CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01052	7 ESSEX WAY	ESSEX	VT	05452	07/01/2025
CH01015D	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #10690	1 DORSET STREET	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015H	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #11037	35 CHURCH ST	BURLINGTON	VT	05401	07/01/2025
CH01015A	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 7103	49 WRIGHT AVE	WILLISTON	VT	05495-4419	07/01/2025
CH01015D	VERMONT CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 01052	7 ESSEX WAY	ESSEX	VT	05452	07/01/2025
CH01015D	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #11037	35 CHURCH ST	BURLINGTON	VT	05401	07/01/2025
CH01015A	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10216	69 MOUNTIAN VIEW DRIVE	COLCHESTER	VT	05446-5919	07/01/2025
CH01015E	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #10690	1 DORSET STREET	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015F	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY #10216	69 MOUNTIAN VIEW DRIVE	COLCHESTER	VT	05446-5919	07/01/2025
CH01015F	VERMONT CVS PHARMACY, L.L.C.	CVS/PHARMACY #10690	1 DORSET STREET	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015G	VERMONT CVS PHARMACY, L.L.C.	DBA CVS/PHARMACY # 7103	49 WRIGHT AVE	WILLISTON	VT	05495-4419	07/01/2025
CH010150	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	10/01/2017
CH01015F	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2025
CH01015D	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2025
CH01015E	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2025
CH01015C	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2025
CH01015G	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2025
CH01015H	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2025
CH01015A	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	07/01/2025
CH010150	WAL-MART PHARMACY 10-2224	863 HARVEST LANE		WILLISTON	VT	05495	08/17/2012
CH01015G	WAL-MART PHARMACY 10-2224	863 HARVEST LANE		WILLISTON	VT	05495	07/01/2025
CH01015A	WAL-MART PHARMACY 10-2224	863 HARVEST LANE		WILLISTON	VT	05495	07/01/2025
CH01015E	WAL-MART PHARMACY 10-2224	863 HARVEST LANE		WILLISTON	VT	05495	07/01/2025
CH01015H	WAL-MART PHARMACY 10-2224	863 HARVEST LANE		WILLISTON	VT	05495	07/01/2025
CH01015C	WAL-MART PHARMACY 10-2224	863 HARVEST LANE		WILLISTON	VT	05495	07/01/2025
CH01015F	WAL-MART PHARMACY 10-2224	863 HARVEST LANE		WILLISTON	VT	05495	07/01/2025
CH01015D	WAL-MART PHARMACY 10-2224	863 HARVEST LANE		WILLISTON	VT	05495	07/01/2025
CH010150	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	10/01/2017
CH01015G	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2025
CH01015F	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2025
CH01015C	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2025
CH01015A	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2025
CH01015H	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2025
CH01015E	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2025
CH01015D	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	07/01/2025
CH010150	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #11526	514 FARRELL ST.	BURLINGTON	VT	05401-6907	04/01/2015	03/19/2025
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #19570	1024 NORTH AVE	BURLINGTON	VT	05408	02/16/2018
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #17183	1184 PRIM RD SUITE 2	COLCHESTER	VT	05446	02/16/2018
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #19449	158 CHERRY ST	BURLINGTON	VT	05401	02/16/2018	11/13/2023
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #17485	321 MAIN ST STE B	WINOOSKI	VT	05404	02/16/2018
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #17447	39 HINESBURG RD	SOUTH BURLINGTON	VT	05403	02/16/2018
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #17471	9 SUSIE WILSON RD	ESSEX JUNCTION	VT	05452	07/01/2018
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #17475	108 CORNERSTONE DR	WILLISTON	VT	05495	07/01/2018	03/21/2023
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #17749	75 PEARL ST	ESSEX JUNCTION	VT	05452	07/01/2018	02/22/2023
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #17747	201 US ROUTE 7 SOUTH	MILTON	VT	05468	04/01/2019
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #19795	133 N MAIN ST SUITE 23	SAINT ALBANS	VT	05478-1735	04/01/2019
CH010150	WALGREEN EASTERN CO., INC.	WALGREENS #18325	30 SHELBURNE SHOPPING PARK	SHELBURNE	VT	05482	04/01/2019
CH01015D	WALGREEN EASTERN CO., INC.	WALGREENS #17747	201 US ROUTE 7 SOUTH	MILTON	VT	05468	07/01/2025
CH01015C	WALGREEN EASTERN CO., INC.	WALGREENS #17485	321 MAIN ST STE B	WINOOSKI	VT	05404	07/01/2025
CH01015F	WALGREEN EASTERN CO., INC.	WALGREENS #17485	321 MAIN ST STE B	WINOOSKI	VT	05404	07/01/2025
CH01015G	WALGREEN EASTERN CO., INC.	WALGREENS #17747	201 US ROUTE 7 SOUTH	MILTON	VT	05468	07/01/2025
CH01015A	WALGREEN EASTERN CO., INC.	WALGREENS #17447	39 HINESBURG RD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015F	WALGREEN EASTERN CO., INC.	WALGREENS #17471	9 SUSIE WILSON RD	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015C	WALGREEN EASTERN CO., INC.	WALGREENS #19570	1024 NORTH AVE	BURLINGTON	VT	05408	07/01/2025
CH01015F	WALGREEN EASTERN CO., INC.	WALGREENS #19570	1024 NORTH AVE	BURLINGTON	VT	05408	07/01/2025
CH01015E	WALGREEN EASTERN CO., INC.	WALGREENS #19570	1024 NORTH AVE	BURLINGTON	VT	05408	07/01/2025
CH01015G	WALGREEN EASTERN CO., INC.	WALGREENS #18325	30 SHELBURNE SHOPPING PARK	SHELBURNE	VT	05482	07/01/2025
CH01015G	WALGREEN EASTERN CO., INC.	WALGREENS #19570	1024 NORTH AVE	BURLINGTON	VT	05408	07/01/2025
CH01015F	WALGREEN EASTERN CO., INC.	WALGREENS #17747	201 US ROUTE 7 SOUTH	MILTON	VT	05468	07/01/2025
CH01015G	WALGREEN EASTERN CO., INC.	WALGREENS #19795	133 N MAIN ST SUITE 23	SAINT ALBANS	VT	05478-1735	07/01/2025
CH01015D	WALGREEN EASTERN CO., INC.	WALGREENS #17471	9 SUSIE WILSON RD	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015G	WALGREEN EASTERN CO., INC.	WALGREENS #17183	1184 PRIM RD SUITE 2	COLCHESTER	VT	05446	07/01/2025
CH01015C	WALGREEN EASTERN CO., INC.	WALGREENS #17183	1184 PRIM RD SUITE 2	COLCHESTER	VT	05446	07/01/2025
CH01015E	WALGREEN EASTERN CO., INC.	WALGREENS #17447	39 HINESBURG RD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015H	WALGREEN EASTERN CO., INC.	WALGREENS #17183	1184 PRIM RD SUITE 2	COLCHESTER	VT	05446	07/01/2025
CH01015A	WALGREEN EASTERN CO., INC.	WALGREENS #17471	9 SUSIE WILSON RD	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015A	WALGREEN EASTERN CO., INC.	WALGREENS #18325	30 SHELBURNE SHOPPING PARK	SHELBURNE	VT	05482	07/01/2025
CH01015D	WALGREEN EASTERN CO., INC.	WALGREENS #17485	321 MAIN ST STE B	WINOOSKI	VT	05404	07/01/2025
CH01015D	WALGREEN EASTERN CO., INC.	WALGREENS #18325	30 SHELBURNE SHOPPING PARK	SHELBURNE	VT	05482	07/01/2025
CH01015E	WALGREEN EASTERN CO., INC.	WALGREENS #17471	9 SUSIE WILSON RD	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015E	WALGREEN EASTERN CO., INC.	WALGREENS #18325	30 SHELBURNE SHOPPING PARK	SHELBURNE	VT	05482	07/01/2025
CH01015D	WALGREEN EASTERN CO., INC.	WALGREENS #17447	39 HINESBURG RD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015E	WALGREEN EASTERN CO., INC.	WALGREENS #17485	321 MAIN ST STE B	WINOOSKI	VT	05404	07/01/2025
CH01015H	WALGREEN EASTERN CO., INC.	WALGREENS #17485	321 MAIN ST STE B	WINOOSKI	VT	05404	07/01/2025
CH01015H	WALGREEN EASTERN CO., INC.	WALGREENS #18325	30 SHELBURNE SHOPPING PARK	SHELBURNE	VT	05482	07/01/2025
CH01015F	WALGREEN EASTERN CO., INC.	WALGREENS #19795	133 N MAIN ST SUITE 23	SAINT ALBANS	VT	05478-1735	07/01/2025
CH01015H	WALGREEN EASTERN CO., INC.	WALGREENS #17471	9 SUSIE WILSON RD	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015G	WALGREEN EASTERN CO., INC.	WALGREENS #17485	321 MAIN ST STE B	WINOOSKI	VT	05404	07/01/2025
CH01015H	WALGREEN EASTERN CO., INC.	WALGREENS #17447	39 HINESBURG RD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015F	WALGREEN EASTERN CO., INC.	WALGREENS #18325	30 SHELBURNE SHOPPING PARK	SHELBURNE	VT	05482	07/01/2025
CH01015H	WALGREEN EASTERN CO., INC.	WALGREENS #19795	133 N MAIN ST SUITE 23	SAINT ALBANS	VT	05478-1735	07/01/2025
CH01015C	WALGREEN EASTERN CO., INC.	WALGREENS #18325	30 SHELBURNE SHOPPING PARK	SHELBURNE	VT	05482	07/01/2025
CH01015F	WALGREEN EASTERN CO., INC.	WALGREENS #17447	39 HINESBURG RD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015A	WALGREEN EASTERN CO., INC.	WALGREENS #17183	1184 PRIM RD SUITE 2	COLCHESTER	VT	05446	07/01/2025
CH01015E	WALGREEN EASTERN CO., INC.	WALGREENS #17747	201 US ROUTE 7 SOUTH	MILTON	VT	05468	07/01/2025
CH01015C	WALGREEN EASTERN CO., INC.	WALGREENS #17471	9 SUSIE WILSON RD	ESSEX JUNCTION	VT	05452	07/01/2025
CH01015E	WALGREEN EASTERN CO., INC.	WALGREENS #17183	1184 PRIM RD SUITE 2	COLCHESTER	VT	05446	07/01/2025
CH01015A	WALGREEN EASTERN CO., INC.	WALGREENS #17747	201 US ROUTE 7 SOUTH	MILTON	VT	05468	07/01/2025
CH01015A	WALGREEN EASTERN CO., INC.	WALGREENS #19570	1024 NORTH AVE	BURLINGTON	VT	05408	07/01/2025
CH01015G	WALGREEN EASTERN CO., INC.	WALGREENS #17447	39 HINESBURG RD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015A	WALGREEN EASTERN CO., INC.	WALGREENS #19795	133 N MAIN ST SUITE 23	SAINT ALBANS	VT	05478-1735	07/01/2025
CH01015H	WALGREEN EASTERN CO., INC.	WALGREENS #17747	201 US ROUTE 7 SOUTH	MILTON	VT	05468	07/01/2025
CH01015D	WALGREEN EASTERN CO., INC.	WALGREENS #17183	1184 PRIM RD SUITE 2	COLCHESTER	VT	05446	07/01/2025
CH01015D	WALGREEN EASTERN CO., INC.	WALGREENS #19795	133 N MAIN ST SUITE 23	SAINT ALBANS	VT	05478-1735	07/01/2025
CH01015F	WALGREEN EASTERN CO., INC.	WALGREENS #17183	1184 PRIM RD SUITE 2	COLCHESTER	VT	05446	07/01/2025
CH01015H	WALGREEN EASTERN CO., INC.	WALGREENS #19570	1024 NORTH AVE	BURLINGTON	VT	05408	07/01/2025
CH01015D	WALGREEN EASTERN CO., INC.	WALGREENS #19570	1024 NORTH AVE	BURLINGTON	VT	05408	07/01/2025
CH01015C	WALGREEN EASTERN CO., INC.	WALGREENS #19795	133 N MAIN ST SUITE 23	SAINT ALBANS	VT	05478-1735	07/01/2025
CH01015C	WALGREEN EASTERN CO., INC.	WALGREENS #17447	39 HINESBURG RD	SOUTH BURLINGTON	VT	05403	07/01/2025
CH01015A	WALGREEN EASTERN CO., INC.	WALGREENS #17485	321 MAIN ST STE B	WINOOSKI	VT	05404	07/01/2025
CH01015C	WALGREEN EASTERN CO., INC.	WALGREENS #17747	201 US ROUTE 7 SOUTH	MILTON	VT	05468	07/01/2025
CH01015E	WALGREEN EASTERN CO., INC.	WALGREENS #19795	133 N MAIN ST SUITE 23	SAINT ALBANS	VT	05478-1735	07/01/2025
CH01015G	WALGREEN EASTERN CO., INC.	WALGREENS #17471	9 SUSIE WILSON RD	ESSEX JUNCTION	VT	05452	07/01/2025
CH010150	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	04/01/2023
CH01015E	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	07/01/2025
CH01015H	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	07/01/2025
CH01015A	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	07/01/2025
CH01015C	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	07/01/2025
CH01015G	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	07/01/2025
CH01015F	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	07/01/2025
CH01015D	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	07/01/2025
CH010150	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	04/01/2015	08/10/2015
CH010150	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	04/01/2015	08/10/2015
CH01015A	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2025
CH01015G	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2025
CH010150	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2025
CH010150	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2025
CH01015C	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2025
CH01015E	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2025
CH01015D	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2025
CH01015H	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2025
CH010150	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2025
CH01015C	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2025
CH01015H	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2025
CH01015D	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2025
CH01015A	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2025
CH01015E	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2025
CH01015D	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2025
CH01015G	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2025
CH01015H	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2025
CH01015E	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2025
CH01015G	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2025
CH01015A	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2025
CH01015F	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2025
CH01015F	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15438	41460 HAGGERTY CIR S	CANTON	MI	48188	07/01/2025
CH01015F	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #15443	10530 JOHN W ELLIOTT DR STE 100	FRISCO	TX	75033	07/01/2025
CH01015C	WALGREENS SPECIALTY PHARMACY, LLC	DBA WALGREENS SPECIALTY PHARMACY #16287	130 ENTERPRISE DR	PITTSBURGH	PA	15275	07/01/2025
CH010150	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	10/01/2023
CH01015E	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025
CH01015G	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025
CH01015D	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025
CH01015H	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025
CH01015A	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025
CH01015F	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025
CH01015C	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	1/29/2024 9:38:10 AM	2/10/2025 8:55:28 AM	2/10/2025 8:55 AM
Details	Last Recertification Date	Update	Recertification	1/30/2023 10:35:53 AM	1/29/2024 9:38:10 AM	1/29/2024 9:38 AM
Contacts	Primary Contact	Update	Change Request	Warsaw, Christopher 340b Specialist Community Health Centers of Burlington 8025408246	Whitehouse, Amy Population Health Analyst Community Health Centers of Burlington 8022648158	3/28/2023 7:56 AM
Details	Last Recertification Date	Update	Recertification	2/7/2022 5:35:55 AM	1/30/2023 10:35:53 AM	1/30/2023 10:35 AM
Details	Last Recertification Date	Update	Recertification	2/4/2021 7:29:12 AM	2/7/2022 5:35:55 AM	2/7/2022 5:35 AM
Contacts	Primary Contact	Update	Change Request	Whitehouse, Amy Business Operations Analyst Community Health Centers of Burlington 8022648158	Warsaw, Christopher 340b Specialist Community Health Centers of Burlington 8025408246	1/6/2022 6:57 AM
Details	Last Recertification Date	Update	Recertification	1/29/2020 9:05:43 AM	2/4/2021 7:29:12 AM	2/4/2021 7:29 AM
Contacts	Authorizing Official	Update	Change Request	Simmons, Dave CFO Community Health Centers of Burlington 8022648197	McKee, Jeffrey CEO Community Health Centers of Burlington 8022648190	8/20/2020 3:33 PM
Details	Last Recertification Date	Update	Recertification	2/1/2019 5:10:02 PM	1/29/2020 9:05:43 AM	1/29/2020 9:05 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	1015558 (VT)		3/14/2019 1:17 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1316195969 ( )		3/14/2019 1:17 PM
Contacts	Primary Contact	Update	Recertification	Kaplan, Julie Quality and Compliance Manager Community Health Centers of Burlington 8022648149	Whitehouse, Amy Business Operations Analyst Community Health Centers of Burlington 8022648158	2/1/2019 5:10 PM
Details	Last Recertification Date	Update	Recertification	2/16/2018 1:47:15 PM	2/1/2019 5:10:02 PM	2/1/2019 5:10 PM
Contacts	Primary Contact	Update	Recertification	Simmons, Dave CFO Community Health Centers of Burlington 8022648197	Kaplan, Julie Quality and Compliance Manager Community Health Centers of Burlington 8022648149	2/16/2018 1:47 PM
Details	Last Recertification Date	Update	Recertification	2/16/2017 12:00:00 AM	2/16/2018 1:47:15 PM	2/16/2018 1:47 PM
Details	Is Authorizing Official EHB Data	Update	Recertification	False		2/16/2018 1:47 PM
Contacts	Authorizing Official	Update	Profile Change Request	Simmons, Dave Finance Director Community Health Centers of Burlington 8022648197	Simmons, Dave CFO Community Health Centers of Burlington 8022648197	2/16/2018 1:09 PM
Contacts	Primary Contact	Update	Profile Change Request	Simmons, Dave Finance Director Community Health Centers of Burlington 8022648197	Simmons, Dave CFO Community Health Centers of Burlington 8022648197	2/16/2018 1:09 PM
Contacts	Authorizing Official	Update		Simmons, Dave Finance Director 8022648197	Simmons, Dave Finance Director Community Health Centers of Burlington 8022648197	2/9/2018 9:33 AM
Contacts	Primary Contact	Update		Simmons, Dave Finance Director 8022648197	Simmons, Dave Finance Director Community Health Centers of Burlington 8022648197	2/9/2018 9:33 AM
Contacts	Authorizing Official	Insert			Simmons, Dave Finance Director 8022648197	7/14/2017 2:32 PM
Contacts	Primary Contact	Insert			Simmons, Dave Finance Director 8022648197	7/14/2017 2:32 PM
Addresses	Main Address	Insert			368 Dorset Street #1 South Burlington, VT 05403	2/16/2017 1:43 PM
Contacts	Signed By	Insert			Robinson, Greg CEO 8028646309	2/16/2017 1:43 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	2/16/2017 1:42 PM
Medicaid Billing	Medicaid: Number	Insert			1015558	2/16/2017 1:42 PM
Medicaid Billing	Medicaid: State	Insert			VT	2/16/2017 1:42 PM
Medicaid Billing	NPI: Number	Insert			1316195969	2/16/2017 1:42 PM
Details	Last Recertification Date	Update			2/16/2017 12:00:00 AM	2/16/2017 1:42 PM
Addresses	Billing Address	Insert			Community Health Centers of Burlington, Inc. 617 Riverside Avenue Burlington, VT 05401	7/15/2016 6:59 PM
Dates	Participating Approval Date	Update			7/15/2016 12:00:00 AM	7/15/2016 6:59 PM
Details	State	Update		Pending	Active	7/15/2016 6:59 PM
Dates	Start Date	Update			10/1/2016 12:00:00 AM	7/15/2016 6:59 PM
Details	340B ID	Update		ONLINE_REG_71418	CH01015F	7/14/2016 10:51 AM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_71418	7/12/2016 12:17 PM
Details	Last Recertification Date	Insert				7/12/2016 12:17 PM
Details	Grant Number	Insert			H80CS00311	7/12/2016 12:17 PM
Details	340B ID	Insert			ONLINE_REG	7/12/2016 12:17 PM
Details	Is Authorizing Official EHB Data	Insert			False	7/12/2016 12:17 PM
Dates	Last Date That 340B Drugs Purchased	Insert				7/12/2016 12:17 PM
Details	Medicare Provider Number	Insert				7/12/2016 12:17 PM
Details	Entity Name	Insert			COMMUNITY HEALTH CENTERS OF BURLINGTON, INC.	7/12/2016 12:17 PM
Details	Program Code	Insert			CH	7/12/2016 12:17 PM
Details	Entity Subname	Insert			GoodHealth	7/12/2016 12:17 PM
Dates	Participating Approval Date	Insert				7/12/2016 12:17 PM
Details	State	Insert			Pending	7/12/2016 12:17 PM
Dates	Registration Date	Insert			7/12/2016 12:00:00 AM	7/12/2016 12:17 PM
Dates	Signed By Date	Insert			7/12/2016 12:00:00 AM	7/12/2016 12:17 PM
Dates	Start Date	Insert				7/12/2016 12:17 PM
Terminations	Termination Comments	Insert				7/12/2016 12:17 PM
Terminations	Termination Date	Insert				7/12/2016 12:17 PM
Terminations	Termination Effective Date	Insert				7/12/2016 12:17 PM
Terminations	Termination Reason	Insert				7/12/2016 12:17 PM

340B Drug Pricing Program Database