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GAUTHIER'S PHARMACY
CH01064G NORTHERN COUNTIES HEALTH CARE, INC
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Covered Entity Details
Entity Name
NORTHERN COUNTIES HEALTH CARE, INC
Subdivision Name
CONCORD HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH01064G
Entity Address
201 EAST MAIN STREET
CONCORD, VT 05824-9730
Grant Number
H80CS00632
Participating Start Date
12/1/1992
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
GAUTHIER'S PHARMACY
Pharmacy Address
415 RAILROAD STREET
ST. JOHNSBURY, VT 05819
Pharmacy Comments
Contract Details
Approval Date
7/5/2012
Contract Begin Date
7/5/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/14/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Thomas Pitts, CFO
(802) 748-9405 Ext: 1599
Contract Pharmacy Representative
Carol Novick, Owner
(802) 748-3122
Signed By Date
6/29/2012
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