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CAH471301-11 GIFFORD MEDICAL CENTER (Terminated)
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Main Details
Name
GIFFORD MEDICAL CENTER
Subdivision Name
TWIN RIVER HEALTH CENTER - GENERAL SURGERY CLINIC (UROLOGY)
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH471301-11
Medicare Provider Number
471301
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/8/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/14/2011
Last Recertification Date
9/19/2022
Termination Date
Termination Reason
10/1/2023
Site closure
Contacts
Authorizing Official
Gifford Health Care
Daniel Bennett, CEO
(802) 728-2304
Primary Contact
Gifford Health Care, Inc.
Dawn M Cogger, 340B Coordinator
(802) 728-2108
Addresses
Street Address
108 NORTH MAIN ST
WHITE RIVER JUNCTION, VT 05001
Billing Address
GIFFORD MEDICAL CENTER
44 SOUTH MAIN STREET
RANDOLPH, VT 05060
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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