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CVS MANCHESTER NH, L.L.C.
CAH301309-00 MONADNOCK COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
MONADNOCK COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH301309-00
Entity Address
452 OLD STREET ROAD
PETERBOROUGH, NH 03458
Medicare Provider Number
301309
Participating Start Date
9/29/2010
Last Recertification Date
9/16/2024
Pharmacy Details
Pharmacy Name
CVS MANCHESTER NH, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 00442
10 WHITEHALL RD.
HOOKSETT, NH 03106
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Scheinblum, CFO
(603) 924-4699 Ext: 1738
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2020
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