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MAXI GREEN, INC.
CH01397G RICHFORD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
RICHFORD HEALTH CENTER, INC.
Subdivision Name
NOTCH Dental Clinic
Type
HRSA-Funded Health Center
340B ID
CH01397G
Entity Address
100 Thunderbird Drive BLDG Dental
Swanton, VT 05488
Grant Number
H80CS00261
Participating Start Date
7/1/2014
Last Recertification Date
2/18/2016
Entity Termination Date
1/1/2017
Pharmacy Details
Pharmacy Name
MAXI GREEN, INC.
Pharmacy Address
RITE AID #10325
133 NORTH MAIN STREET SUITE 23
ST. ALBANS, VT 05478
Pharmacy Comments
Contract Details
Approval Date
4/2/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2017
Contacts
Covered Entity Signing Official
PAMELA PARSONS, CEO
(802) 255-5561 Ext: 561
Contract Pharmacy Representative
Rite Aid Corp.
Wendy Barnes, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
4/2/2014
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