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COMMUNITY HEALTH PHARMACY
CH01064P NORTHERN COUNTIES HEALTH CARE INC
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Covered Entity Details
Entity Name
NORTHERN COUNTIES HEALTH CARE INC
Subdivision Name
Northern Express Care Newport
Type
HRSA-Funded Health Center
340B ID
CH01064P
Entity Address
137 Main St STE 102
Newport, VT 05855-4415
Grant Number
H80CS00632
Participating Start Date
1/1/2023
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
4/3/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Angela Neil, CFO
(802) 748-9405 Ext: 1599
Contract Pharmacy Representative
Maxor
Ivonne de Marchena, Regional VP
(305) 989-8804
Signed By Date
4/3/2023
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