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DARTMOUTH-HITCHCOCK PHARMACY
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
DARTMOUTH-HITCHCOCK PHARMACY
Pharmacy Address
1000 QUALITY DR
HOOKSETT, NH 03106
Pharmacy Comments
Contract Details
Approval Date
1/13/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Scheinblum, CFO
(603) 924-4699 Ext: 1738
Contract Pharmacy Representative
Dartmouth-Hitchcock
Patrick F. Jordan, Chief Operating Officier
(603) 650-5706
Signed By Date
1/13/2022
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