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DSH470003BM UNIVERSITY OF VERMONT MEDICAL CENTER (Terminated)
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Main Details
Name
UNIVERSITY OF VERMONT MEDICAL CENTER
Subdivision Name
UVMMC - SAN REMO DRIVE / MRI-San Remo Drive
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH470003BM
Medicare Provider Number
470003
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/11/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/15/2017
Last Recertification Date
Termination Date
Termination Reason
1/1/2018
Site closure
Contacts
Authorizing Official
University of Vermont Medical Center
Christina Oliver, VP of Clinical Services
(802) 847-2805
Primary Contact
University of Vermont Medical Center
Gary Paul Bergeron, Pharmacy Supervisor
(802) 847-3962
Addresses
Street Address
6 SAN REMO DR
SOUTH BURLINGTON, VT 05403-6310
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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