340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CHC26642-00 FIVE-TOWN HEALTH ALLIANCE, INC. (Active)
Print
Main Details
Name
FIVE-TOWN HEALTH ALLIANCE, INC.
Subdivision Name
Mountain Community Health
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013222
340B ID
CHC26642-00
Grant Number
H80CS26642
Additional Details
Current Program Status
Active
Registration Date
12/23/2013
Participating Start Date
1/1/2014
Participating Approval Date
12/23/2013
Last Recertification Date
2/25/2025
Contacts
Authorizing Official
Five Town Health Alliance, Inc
Jennifer Wisdom-Behounek, Medical Director
(802) 453-6874
Primary Contact
Mountain Community Health
Heidi S. Melbostad, CEO
(858) 344-1912
Addresses
Street Address
61 Pine St Bldg 4
BRISTOL, VT 05443
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
12/23/13 organization registered during October registration window as FQHCLA, which was its entity type at that time, but received grant funding in November so was allowed to register late under its new entity type
12/23/2013
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session