340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DARTMOUTH-HITCHCOCK PHARMACY AT CENTERRA
CAH471301-14 GIFFORD MEDICAL CENTER
Print
Covered Entity Details
Entity Name
GIFFORD MEDICAL CENTER
Subdivision Name
GIFFORD HEALTH CENTER AT BERLIN - SPECIALTY CLINICS
Type
Critical Access Hospital
340B ID
CAH471301-14
Entity Address
82 EAST VIEW LANE
BARRE, VT 05641-5713
Medicare Provider Number
471301
Outpatient Facility Provider Number
Participating Start Date
7/1/2011
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
DARTMOUTH-HITCHCOCK PHARMACY AT CENTERRA
Pharmacy Address
12 CENTERRA PKWY STE 10
LEBANON, NH 03766
Pharmacy Comments
Contract Details
Approval Date
10/12/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Daniel Bennett, CEO
(802) 728-2304
Contract Pharmacy Representative
Mary Hitchcock Memorial Hospital
Curtis A. Gibbon, Director - Retail Pharmacy
(603) 308-2287
Signed By Date
10/12/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session