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RRC470012-00 SOUTHWESTERN VERMONT MEDICAL CENTER (Active)
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Main Details
Name
SOUTHWESTERN VERMONT MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC470012-00
Medicare Provider Number
470012
Additional Details
Current Program Status
Active
Registration Date
7/10/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/12/2014
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
SVHC
Robert Laba, Chief Financial Officer
(802) 447-5011
Primary Contact
Dartmouth-Hitchcock
Kristin A Chupka, Director - Pharmacy System 340B Program
(603) 656-0945
Addresses
Street Address
100 HOSPITAL DR
BENNINGTON, VT 05201
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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