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COMMUNITY HEALTH PHARMACY
CH01064A NORTHERN COUNTIES HEALTH CARE, INC
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Covered Entity Details
Entity Name
NORTHERN COUNTIES HEALTH CARE, INC
Subdivision Name
ISLAND POND HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH01064A
Entity Address
82 MAPLE STREET
ISLAND POND, VT 05846-0425
Grant Number
H80CS00632
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
COMMUNITY HEALTH PHARMACY
Pharmacy Address
158 BRENTWOOD DR STE 6
COLCHESTER, VT 05446-7994
Pharmacy Comments
Contract Details
Approval Date
10/20/2011
Contract Begin Date
11/1/2008
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
10/8/2008
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