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COMMUNITY HEALTH PHARMACY
CH01397H RICHFORD HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
RICHFORD HEALTH CENTER, INC.
Subdivision Name
Fairfield Street Health Center
Type
HRSA-Funded Health Center
340B ID
CH01397H
Entity Address
77 Fairfield Street
Saint Albans, VT 05478-1716
Grant Number
H80CS00261
Participating Start Date
4/1/2016
Last Recertification Date
1/30/2019
Entity Termination Date
4/1/2019
Pharmacy Details
Pharmacy Name
COMMUNITY HEALTH PHARMACY
Pharmacy Address
158 BRENTWOOD DR STE 6
COLCHESTER, VT 05446-7994
Pharmacy Comments
Contract Details
Approval Date
2/10/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
RAMESH UPADHYAYULA, DIRECTOR OF PHARMACY
(301) 945-4534
Signed By Date
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