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WILCOX PHARMACY
CH0112230 COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION
Subdivision Name
CHC'S OF RUTLAND REGION, INC.
Type
HRSA-Funded Health Center
340B ID
CH0112230
Entity Address
275 Route 30 N
Bomoseen, VT 05732-9647
Grant Number
H80CS06659
Participating Start Date
7/1/2006
Last Recertification Date
2/27/2025
Pharmacy Details
Pharmacy Name
WILCOX PHARMACY
Pharmacy Address
252 STRATTON ROAD
RUTLAND, VT 05701
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/20/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Donald James Reuther, CEO
(802) 855-2083
Contract Pharmacy Representative
Smith Management Services
CARRIE TENNIS, DIRECTOR OF OPERATIONS
(417) 581-4335
Signed By Date
1/15/2020
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