340B Drug Pricing Program Database
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CAH301305-04 ALICE PECK DAY MEMORIAL HOSPITAL (Active)
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Main Details
Name
ALICE PECK DAY MEMORIAL HOSPITAL
Subdivision Name
MSC Orthopaedics - Orthopaedic Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH301305-04
Medicare Provider Number
301305
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/2/2020
Participating Start Date
4/1/2020
Participating Approval Date
1/3/2020
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Alice Peck Day Memorial Hospital
Paula Seaman, CNO
(603) 308-0089
Primary Contact
Dartmouth-Hitchcock
Kristin A Chupka, Director - Pharmacy System 340B Program
(603) 656-0945
Addresses
Street Address
9 Alice Peck Day Drive
Lebanon, NH 03766
Billing Address
Alice Peck Day Memorial Hospital
10 Alice Peck Day Drive
Lebanon, NH 03766
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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