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KPH HEALTHCARE SERVICES, INC.
CHC26798-00 Gifford Health Care, Inc.
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Covered Entity Details
Entity Name
Gifford Health Care, Inc.
Subdivision Name
Gifford Primary Care
Type
HRSA-Funded Health Center
340B ID
CHC26798-00
Entity Address
44 S. Main St STE 2
Randolph, VT 05060
Grant Number
H80CS26798
Participating Start Date
7/1/2014
Last Recertification Date
2/22/2025
Pharmacy Details
Pharmacy Name
KPH HEALTHCARE SERVICES, INC.
Pharmacy Address
KINNEY DRUGS #110
356 VERMONT ROUTE 110
CHELSEA, VT 05038
Pharmacy Comments
Contract Details
Approval Date
6/9/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/7/2018
Pharmacy closed
Contacts
Covered Entity Signing Official
Jeff Hebert, CFO
(802) 728-2356
Contract Pharmacy Representative
Kinney Drugs
Debbi Barber, Dir. PBM Relations
(315) 287-3600 Ext: 2423
Signed By Date
6/9/2014
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