340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH470011H Brattleboro Memorial Hospital (Terminated)
Print
Main Details
Name
Brattleboro Memorial Hospital
Subdivision Name
BMH ORTHOPAEDICS AND SPORTS MEDICIN
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH470011H
Medicare Provider Number
470011
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/5/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/18/2016
Last Recertification Date
8/20/2018
Termination Date
Termination Reason
4/1/2019
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Brattleboro Memorial Hospital
Michael Rogers, Vice President, Finance
(802) 257-8279
Primary Contact
Brattleboro Memorial Hospital
Deanna Auger, Certified Pharmacy Technician
(802) 257-8267
Addresses
Street Address
17 BELMONT AVE 1
BRATTLEBORO, VT 05301-7602
Billing Address
Brattleboro Memorial Hospital
17 Belmont Avenue
Brattleboro, VT 05301
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
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