Covered Entity Details

CAH471307-13 Porter Hospital (Active) - information as of 6/26/2025 3:04:03 AM

Main Details

Name

Porter Hospital

Subdivision Name

Porter General Surgery

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH471307-13

Medicare Provider Number

471307

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/14/2020

Participating Start Date

7/1/2020

Participating Approval Date

5/1/2020

Last Recertification Date

8/21/2024

Contacts

Authorizing Official

Porter Medical Center/Elizabethtown Community Hospital
Scott Alan Comeau, Vice President/Chief Financial Officer
(802) 388-4752

Primary Contact

Porter Medical Center / Elizabethtown Community Hospital
Renee Mosier, Pharmacy Director
(802) 388-4701 Ext: 5624

Addresses

Street Address

116 PORTER DR
MIDDLEBURY, VT 05753-8501

Billing Address

Porter Hospital
115 Porter Drive
Middlebury, VT 05753

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

Porter Hospital
115 Porter Drive
Middlebury, VT 05753

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
CAH471307-01	Child	CAH	PORTER HOSPITAL	Porter Internal Medicine	116 Porter Drive	Middlebury	VT	Terminated
CAH471307-02	Child	CAH	Porter Hospital	Porter Primary Care Middlebury	82 Catamount Park - Exchange Street	Middlebury	VT	Active
CAH471307-03	Child	CAH	UVM Health Network/Porter Medical Center	UVM Health Network/Porter Primary Care Bristol	61 Pine Street Bldg. 4, Suite 400	Bristol	VT	Terminated
CAH471307-04	Child	CAH	Porter Hospital	Porter Primary Care Vergennes	10 North Street	Vergennes	VT	Active
CAH471307-05	Child	CAH	PORTER HOSPITAL	Tapestry Midwifery	20 Armory Lane	Vergennes	VT	Terminated
CAH471307-06	Child	CAH	Porter Hospital	Porter Women's Health	PMC Physicians Building	Middlebury	VT	Active
CAH471307-07	Child	CAH	Porter Hospital	Pediatric Primary Care	44 Collins Drive	Middlebury	VT	Active
CAH471307-08	Child	CAH	Porter Hospital	Porter Orthopedics	1436 Exchange Street	Middlebury	VT	Active
CAH471307-09	Child	CAH	Porter Hospital	Porter Cardiology	115 Porter Drive	Middlebury	VT	Terminated
CAH471307-10	Child	CAH	Porter Hospital	Porter ENT Middlebury	PMC Physicians Building	Middlebury	VT	Active
CAH471307-11	Child	CAH	Porter Hospital	Porter Primary Care Brandon	61 Court Street	Brandon	VT	Active
CAH471307-12	Child	CAH	Porter Hospital	Porter Podiatry	116 Porter Drive	Middlebury	VT	Active
CAH471307-13	Child	CAH	Porter Hospital	Porter General Surgery	116 PORTER DR	MIDDLEBURY	VT	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	Comeau, Scott Alan CFO Elizabethtown Community Hospital 8023884752	Comeau, Scott Alan Vice President/Chief Financial Officer Porter Medical Center/Elizabethtown Community Hospital 8023884752	5/28/2025 7:49 AM
Contacts	Primary Contact	Update	Profile Change Request	Mosier, Renee Pharmacy Director Porter Medical Center 8023884701-5624	Mosier, Renee Pharmacy Director Porter Medical Center / Elizabethtown Community Hospital 8023884701-5624	5/15/2025 12:14 PM
Details	Last Recertification Date	Update	Recertification	8/28/2023 11:34:38 AM	8/21/2024 9:00:07 AM	8/21/2024 9:00 AM
Details	Last Recertification Date	Update	Recertification	9/8/2022 3:53:08 PM	8/28/2023 11:34:38 AM	8/28/2023 11:34 AM
Addresses	Billing Address	Update	Change Request	Porter Medical Center 115 Porter Drive Middlebury, VT 05753	Porter Hospital 115 Porter Drive Middlebury, VT 05753	7/5/2023 6:48 AM
Addresses	Shipping Address	Update	Change Request	Porter Medical Center 115 Porter Drive Middlebury, VT 05753	Porter Hospital 115 Porter Drive Middlebury, VT 05753	7/5/2023 6:48 AM
Details	Entity Subname	Update	Change Request	PMC GENERAL SURGERY - Porter General Surgery	Porter General Surgery	7/5/2023 6:48 AM
Contacts	Authorizing Official	Update	Change Request	Leyden, Michael Associate Vice President - Operations Porter Medical Center 8023888855	Comeau, Scott Alan CFO Elizabethtown Community Hospital 8023884752	7/5/2023 6:48 AM
Details	Last Recertification Date	Update	Recertification	9/7/2021 1:39:10 PM	9/8/2022 3:53:08 PM	9/8/2022 3:53 PM
Details	Last Recertification Date	Update	Recertification	8/21/2020 1:05:22 PM	9/7/2021 1:39:10 PM	9/7/2021 1:39 PM
Addresses	Shipping Address	Insert	Change Request		Porter Medical Center 115 Porter Drive Middlebury, VT 05753	6/10/2021 2:02 PM
Contacts	Authorizing Official	Update	Change Request	Beinhaur, Karen CNO UVMHN-Porter Medical Center 8023885637	Leyden, Michael Associate Vice President - Operations Porter Medical Center 8023888855	2/12/2021 11:15 AM
Details	Last Recertification Date	Update	Recertification		8/21/2020 1:05:22 PM	8/21/2020 1:05 PM
Details	State	Update		Approved	Active	7/1/2020 12:00 AM
Contacts	Signed By	Insert	New Registration		Beinhaur, Karen CNO UVMHN-Porter Medical Center 8023885637	5/1/2020 9:31 AM
Details	340B ID	Update	New Registration		CAH471307-13	5/1/2020 9:31 AM
Details	Entity Name	Update	New Registration	PORTER HOSPITAL	Porter Hospital	5/1/2020 9:31 AM
Details	Entity Subname	Update	New Registration	PMC GENERAL SURGERY	PMC GENERAL SURGERY - Porter General Surgery	5/1/2020 9:31 AM
Dates	Participating Approval Date	Update	New Registration		5/1/2020 9:31:05 AM	5/1/2020 9:31 AM
Details	State	Update	New Registration	Pending	Approved	5/1/2020 9:31 AM
Dates	Signed By Date	Update	New Registration		4/30/2020 10:25:39 AM	5/1/2020 9:31 AM
Dates	Start Date	Update	New Registration		7/1/2020 12:00:00 AM	5/1/2020 9:31 AM
Addresses	Main Address	Insert	New Registration		116 PORTER DR MIDDLEBURY, VT 05753-8501	4/14/2020 10:58 AM
Addresses	Billing Address	Insert	New Registration		Porter Medical Center 115 Porter Drive Middlebury, VT 05753	4/14/2020 10:58 AM
Contacts	Authorizing Official	Insert	New Registration		Beinhaur, Karen CNO UVMHN-Porter Medical Center 8023885637	4/14/2020 10:58 AM
Contacts	Primary Contact	Insert	New Registration		Mosier, Renee Pharmacy Director Porter Medical Center 8023884701-5624	4/14/2020 10:58 AM
Details	Last Recertification Date	Insert	New Registration			4/14/2020 10:58 AM
Details	Grant Number	Insert	New Registration			4/14/2020 10:58 AM
Details	340B ID	Insert	New Registration			4/14/2020 10:58 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/14/2020 10:58 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/14/2020 10:58 AM
Details	Medicare Provider Number	Insert	New Registration		471307	4/14/2020 10:58 AM
Details	Entity Name	Insert	New Registration		PORTER HOSPITAL	4/14/2020 10:58 AM
Details	Program Code	Insert	New Registration		CAH	4/14/2020 10:58 AM
Details	Entity Subname	Insert	New Registration		PMC GENERAL SURGERY	4/14/2020 10:58 AM
Dates	Participating Approval Date	Insert	New Registration			4/14/2020 10:58 AM
Details	State	Insert	New Registration		Pending	4/14/2020 10:58 AM
Dates	Registration Date	Insert	New Registration		4/14/2020 10:58:52 AM	4/14/2020 10:58 AM
Dates	Signed By Date	Insert	New Registration			4/14/2020 10:58 AM
Dates	Start Date	Insert	New Registration			4/14/2020 10:58 AM
Terminations	Termination Comments	Insert	New Registration			4/14/2020 10:58 AM
Terminations	Termination Date	Insert	New Registration			4/14/2020 10:58 AM
Terminations	Termination Effective Date	Insert	New Registration			4/14/2020 10:58 AM
Terminations	Termination Reason	Insert	New Registration			4/14/2020 10:58 AM