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DARTMOUTH-HITCHCOCK PHARMACY
CAH301304-00 THE NEW LONDON HOSPITAL ASSOCIATION, INC
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Covered Entity Details
Entity Name
THE NEW LONDON HOSPITAL ASSOCIATION, INC
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH301304-00
Entity Address
273 COUNTY ROAD
NEW LONDON, NH 03257
Medicare Provider Number
301304
Participating Start Date
9/20/2010
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
DARTMOUTH-HITCHCOCK PHARMACY
Pharmacy Address
1000 QUALITY DR
HOOKSETT, NH 03106
Pharmacy Comments
Contract Details
Approval Date
10/18/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/26/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Bruce King, Chief Executive Officer
(603) 526-5512
Contract Pharmacy Representative
Dartmouth-Hitchcock Health
Linda M Sawyer, Sr Director Pharmacy Retail and Specialty Pharmacy
(603) 308-2282
Signed By Date
10/18/2016
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