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KPH HEALTHCARE SERVICES, INC.
CH011222A LITTLE RIVERS HEALTH CARE, INC.
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Covered Entity Details
Entity Name
LITTLE RIVERS HEALTH CARE, INC.
Subdivision Name
BRADFORD
Type
HRSA-Funded Health Center
340B ID
CH011222A
Entity Address
437 S Main St
Bradford, VT 05033
Grant Number
H80CS06658
Participating Start Date
4/1/2008
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
KPH HEALTHCARE SERVICES, INC.
Pharmacy Address
KINNEY DRUGS #56
901 LOWER PLAIN
BRADFORD, VT 05033
Pharmacy Comments
Contract Details
Approval Date
10/20/2011
Contract Begin Date
9/1/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GAIL AUCLAIR, CEO
(802) 222-4637 Ext: 104
Contract Pharmacy Representative
Owen Halloran, Senior Vice President, Pharmacy Procurement
(315) 287-3600 Ext: 263
Signed By Date
7/27/2010
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