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KPH HEALTHCARE SERVICES, INC.
CH010640 NORTHERN COUNTIES HEALTH CARE, INC
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Covered Entity Details
Entity Name
NORTHERN COUNTIES HEALTH CARE, INC
Subdivision Name
NORTHERN COUNTIES HEALTH CARE, INC.
Type
HRSA-Funded Health Center
340B ID
CH010640
Entity Address
165 Sherman Dr
Saint Johnsbury, VT 05819-9811
Grant Number
H80CS00632
Participating Start Date
9/1/2008
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
KPH HEALTHCARE SERVICES, INC.
Pharmacy Address
KINNEY DRUGS #23
97 MORRISVILLE PLAZA
PO BOX 979
MORRISVILLE, VT 05661
Pharmacy Comments
Contract Details
Approval Date
7/30/2012
Contract Begin Date
7/30/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas Pitts, CFO
(802) 748-9405 Ext: 1599
Contract Pharmacy Representative
Kinney Drugs
Debbi Barber, Director of Pharmacy Programs
(315) 287-3600 Ext: 2423
Signed By Date
7/13/2012
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