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CAH301310-00 ANDROSCOGGIN VALLEY HOSPITAL , Inc. (Active)
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Main Details
Name
ANDROSCOGGIN VALLEY HOSPITAL , Inc.
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH301310-00
Medicare Provider Number
301310
Additional Details
Current Program Status
Active
Registration Date
9/23/2010
Participating Start Date
9/29/2010
Participating Approval Date
9/24/2010
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Androscoggin Valley Hospital
Suzanne Landry, Vice President
(603) 326-5608
Primary Contact
North Country Health
Susan Ann Reed, Pharmacy Operations Director
(603) 388-4215
Addresses
Street Address
59 PAGE HILL ROAD
BERLIN, NH 03570-3542
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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1/17/12 - Deleted NPI #s(was 1386680593,1134266679)
01/17/2012
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