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DSH470011 Brattleboro Memorial Hospital (Active)
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Main Details
Name
Brattleboro Memorial Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH470011
Medicare Provider Number
470011
Additional Details
Current Program Status
Active
Registration Date
4/10/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/13/2014
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Brattleboro Memorial Hospital
Laura Bruno, Interium Chief Financial Officer
(802) 257-8385
Primary Contact
Brattleboro Memorial Hospital
Shelly Gonthier, 340B Program Coordinator
(802) 257-8267
Addresses
Street Address
17 Belmont Avenue
Brattleboro, VT 05301
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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