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CAH471307-00 Porter Hospital (Active)
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Main Details
Name
Porter Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH471307-00
Medicare Provider Number
471307
Additional Details
Current Program Status
Active
Registration Date
8/2/2010
Participating Start Date
9/27/2010
Participating Approval Date
8/3/2010
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Elizabethtown Community Hospital
Scott Alan Comeau, CFO
(802) 388-4752
Primary Contact
Porter Medical Center
Renee Mosier, Pharmacy Director
(802) 388-4701 Ext: 5624
Addresses
Street Address
115 PORTER DRIVE
MIDDLEBURY, VT 05753
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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10/27/11 Removed NPI # (was 1740291400)
10/27/2011
April 2025
April 2025
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