Covered Entity Details

CAH471302-05 WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER (Active) - information as of 6/17/2025 11:44:31 PM

Main Details

Name

WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER

Subdivision Name

WINDSOR HOSPITAL CORPORATION - Psychiatry

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH471302-05

Medicare Provider Number

471302

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/15/2021

Participating Start Date

7/1/2021

Participating Approval Date

4/20/2021

Last Recertification Date

8/29/2024

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

32 PLEASANT ST
WOODSTOCK, VT 05091-1122

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

Shipping Address 1

Windsor Hospital Corporation D/B/A Mt. Ascutney Hospital and Health Center
289 County Road
Windsor, VT 05089

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
CAH471302-01	Child	CAH	WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER	WINDSOR HOSPITAL CORPORATION / Podiatry	32 PLEASANT ST	WOODSTOCK	VT	Terminated
CAH471302-02	Child	CAH	WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER	WINDSOR HOSPITAL CORP / Primary Care	32 PLEASANT ST	WOODSTOCK	VT	Active
CAH471302-03	Child	CAH	WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER	WINDSOR HOSPITAL CORPORATION / Ophthamology	32 PLEASANT ST	WOODSTOCK	VT	Terminated
CAH471302-04	Child	CAH	WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER	WINDSOR HOSPITAL CORPORATION-Ophthalmology	80S MAIN ST	HANOVER	NH	Active
CAH471302-05	Child	CAH	WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER	WINDSOR HOSPITAL CORPORATION - Psychiatry	32 PLEASANT ST	WOODSTOCK	VT	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Shipping Address	Insert	Group Change Request		Windsor Hospital Corporation D/B/A Mt. Ascutney Hospital and Health Center 289 County Road Windsor, VT 05089	4/16/2025 8:48 AM
Contacts	Primary Contact	Update	Recertification	Graves, Tanya Lynn Financial Analyst Windsor Hospital Corporation d/b/a Mt. Ascutney Hospital and Health Center 8026747075	Chupka, Kristin A Director - Pharmacy System 340B Program Dartmouth-Hitchcock 6036560945	8/29/2024 12:50 PM
Details	Last Recertification Date	Update	Recertification	8/15/2023 1:26:41 PM	8/29/2024 12:50:17 PM	8/29/2024 12:50 PM
Contacts	Authorizing Official	Update	Change Request	Iannoni, Francis Joseph Interim Chief Financial Officer Windsor Hospital Corporation DBA Mt. Ascutney Hospital and Health Center 8026747240	Pitts, Celeste CFO Mt Ascutney Hospital and Health Center 6035423421	8/2/2024 11:08 AM
Contacts	Authorizing Official	Update	Change Request	Sanville, David C. Chief Financial Officer Windsor Hospital Corporation DBA MT. Ascutney Hospital and Health Center 8026747240	Iannoni, Francis Joseph Interim Chief Financial Officer Windsor Hospital Corporation DBA Mt. Ascutney Hospital and Health Center 8026747240	2/28/2024 8:48 AM
Details	Last Recertification Date	Update	Recertification	9/16/2022 4:06:32 PM	8/15/2023 1:26:41 PM	8/15/2023 1:26 PM
Details	Last Recertification Date	Update	Recertification	9/12/2021 4:27:11 PM	9/16/2022 4:06:32 PM	9/16/2022 4:06 PM
Details	Last Recertification Date	Update	Recertification		9/12/2021 4:27:11 PM	9/12/2021 4:27 PM
Details	State	Update		Approved	Active	7/1/2021 12:01 AM
Contacts	Signed By	Insert	New Registration		Sanville, David C. Chief Financial Officer Windsor Hospital Corporation DBA MT. Ascutney Hospital and Health Center 8026747240	4/20/2021 2:15 PM
Details	340B ID	Update	New Registration		CAH471302-05	4/20/2021 2:15 PM
Details	Entity Name	Update	New Registration	MT ASCUTNEY HOSPITAL AND HEALTH CENT	WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER	4/20/2021 2:15 PM
Details	Entity Subname	Update	New Registration	WINDSOR HOSPITAL CORPORATION	WINDSOR HOSPITAL CORPORATION - Psychiatry	4/20/2021 2:15 PM
Dates	Participating Approval Date	Update	New Registration		4/20/2021 2:15:59 PM	4/20/2021 2:15 PM
Details	State	Update	New Registration	Pending	Approved	4/20/2021 2:15 PM
Dates	Signed By Date	Update	New Registration		4/19/2021 4:45:40 PM	4/20/2021 2:15 PM
Dates	Start Date	Update	New Registration		7/1/2021 12:00:00 AM	4/20/2021 2:15 PM
Addresses	Main Address	Insert	New Registration		32 PLEASANT ST WOODSTOCK, VT 05091-1122	4/15/2021 9:58 PM
Contacts	Primary Contact	Insert	New Registration		Graves, Tanya Lynn Financial Analyst Windsor Hospital Corporation d/b/a Mt. Ascutney Hospital and Health Center 8026747075	4/15/2021 9:58 PM
Contacts	Authorizing Official	Insert	New Registration		Sanville, David C. Chief Financial Officer Windsor Hospital Corporation DBA MT. Ascutney Hospital and Health Center 8026747240	4/15/2021 9:58 PM
Details	Assistance Received From Date	Insert	New Registration			4/15/2021 9:58 PM
Details	Assistance Received To Date	Insert	New Registration			4/15/2021 9:58 PM
Details	Last Recertification Date	Insert	New Registration			4/15/2021 9:58 PM
Details	Grant Number	Insert	New Registration			4/15/2021 9:58 PM
Details	340B ID	Insert	New Registration			4/15/2021 9:58 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/15/2021 9:58 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/15/2021 9:58 PM
Details	Medicare Provider Number	Insert	New Registration		471302	4/15/2021 9:58 PM
Details	Entity Name	Insert	New Registration		MT ASCUTNEY HOSPITAL AND HEALTH CENT	4/15/2021 9:58 PM
Details	NOFO Number	Insert	New Registration			4/15/2021 9:58 PM
Details	Program Code	Insert	New Registration		CAH	4/15/2021 9:58 PM
Details	Entity Subname	Insert	New Registration		WINDSOR HOSPITAL CORPORATION	4/15/2021 9:58 PM
Dates	Participating Approval Date	Insert	New Registration			4/15/2021 9:58 PM
Details	State	Insert	New Registration		Pending	4/15/2021 9:58 PM
Dates	Registration Date	Insert	New Registration		4/15/2021 9:58:49 PM	4/15/2021 9:58 PM
Dates	Signed By Date	Insert	New Registration			4/15/2021 9:58 PM
Dates	Start Date	Insert	New Registration			4/15/2021 9:58 PM
Terminations	Termination Comments	Insert	New Registration			4/15/2021 9:58 PM
Terminations	Termination Date	Insert	New Registration			4/15/2021 9:58 PM
Terminations	Termination Effective Date	Insert	New Registration			4/15/2021 9:58 PM
Terminations	Termination Reason	Insert	New Registration			4/15/2021 9:58 PM