340B Drug Pricing Program Database
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SCH470024-00 Northwestern Medical Center, Inc. (Active)
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Main Details
Name
Northwestern Medical Center, Inc.
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH470024-00
Medicare Provider Number
470024
Additional Details
Current Program Status
Active
Registration Date
11/30/2011
Participating Start Date
1/1/2012
Participating Approval Date
12/21/2011
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Northwestern Medical Center, Inc.
Stephanie Alicia Breault, CFO
(802) 524-8823
Primary Contact
Northwestern Medical Center
Jessica Aboelezz, Director of Pharmacy
(802) 524-8878
Addresses
Street Address
133 Fairfield Street
St. Albans, VT 05478
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/24/12 - Updated entity addr zip code (was 05446)
02/24/2012
April 2025
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