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WALGREEN EASTERN CO., INC.
CAH471302-00 WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER
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Covered Entity Details
Entity Name
WINDSOR HOSPITAL CORPORATION D/B/A MT. ASCUTNEY HOSPITAL AND HEALTH CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH471302-00
Entity Address
289 COUNTY ROAD
WINDSOR, VT 05089
Medicare Provider Number
471302
Participating Start Date
7/1/2011
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS # 09177
3 AIRPORT RD
WEST LEBANON, NH 03784
Pharmacy Comments
Contract Details
Approval Date
4/15/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin W. Donovan, Chief Executive Officer
(802) 674-7255
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/15/2016
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