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HM2673 DARTMOUTH-HITCHCOCK HEMOPHILIA CENTER (Active)
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Main Details
Name
DARTMOUTH-HITCHCOCK HEMOPHILIA CENTER
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM2673
Grant Number
H30MC24048
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
8/7/2003
Last Recertification Date
3/3/2025
Contacts
Authorizing Official
Dartmouth Health
Keith B Thomasset, Chief Pharmacy Officer
(603) 656-0966
Primary Contact
Dartmouth-Hitchcock
Kristin A Chupka, Director - Pharmacy System 340B Program
(603) 656-0945
Addresses
Street Address
1 MEDICAL CENTER DR.
LEBANON, NH 03756
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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April 2025
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