340B Drug Pricing Program Database

Name

UVM Health Network/Porter Medical Center

Subdivision Name

UVM Health Network/Porter Primary Care Bristol

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH471307-03

Medicare Provider Number

471307

Outpatient Facility Provider Number

Current Program Status

Terminated

Registration Date

4/27/2012

Participating Start Date

7/1/2012

Participating Approval Date

5/23/2012

Last Recertification Date

8/28/2018

Termination Date
Termination Reason

7/1/2019
Site closure

Authorizing Official

UVMHN-Porter Medical Center
Karen Beinhaur, CNO
(802) 388-5637

Primary Contact

Porter Medical Center / Elizabethtown Community Hospital
Renee Mosier, Pharmacy Director
(802) 388-4701 Ext: 5624

Street Address

61 Pine Street Bldg. 4, Suite 400
Bristol, VT 05443

Billing Address

UVM Health Network/Primary Care Bristol
115 Porter Drive
Middlebury, VT 05753