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CVS PHARMACY, INC.
CAH471302-00 WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER
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Covered Entity Details
Entity Name
WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH471302-00
Entity Address
289 COUNTY ROAD
WINDSOR, VT 05089
Medicare Provider Number
471302
Participating Start Date
7/1/2011
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 02125
137 WEST CENTRAL STREET
NATICK, MA 01760
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David C. Sanville, Chief Financial Officer
(802) 674-7240
Contract Pharmacy Representative
CVS Health
Christian Reid, 340B Program Director
(401) 770-2118
Signed By Date
1/15/2021
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