MARY HITCHCOCK MEMORIAL HOSPITAL (Credential# 1523472) is licensed (Nonresident Pharmacy) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2019. The license expiration date date is August 31, 2020. The license status is ACTIVE.
MARY HITCHCOCK MEMORIAL HOSPITAL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #PCN.0003504. The credential type is nonresident pharmacy. The effective date is September 1, 2019. The expiration date is August 31, 2020. The business address is 12 Centerra Pkwy Ste 10, Lebanon, NH 03766-1411. The current status is active.
| Licensee Name | MARY HITCHCOCK MEMORIAL HOSPITAL |
| Business Name | MARY HITCHCOCK MEMORIAL HOSPITAL |
| Doing Business As | DARTMOUTH-HITCHCOCK PHARMACY AT CENTERRA |
| Credential ID | 1523472 |
| Credential Number | PCN.0003504 |
| Credential Type | NONRESIDENT PHARMACY |
| Business Address |
12 Centerra Pkwy Ste 10 Lebanon NH 03766-1411 |
| Business Type | BUSINESS |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-09-27 |
| Effective Date | 2019-09-01 |
| Expiration Date | 2020-08-31 |
| Refresh Date | 2019-07-16 |
| Street Address | 12 CENTERRA PKWY STE 10 |
| City | LEBANON |
| State | NH |
| Zip Code | 03766-1411 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gail Denise Fancher | 85 Mechanic Street, Lebanon, NH 03766 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Taylor M Harkness | 337 Mount Support Rd Unit 206, Lebanon, NH 03766 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Ashley E Johnson | 7 Timberwood Drive Unit 212, Lebanon, NH 03766 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Philip R Benoit | 337 Mount Support Road, Lebanon, NH 03766 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Lisa Anne Kaestle | 4 Cedarwood Lane, Unit 302, Lebanon, NH 03766 | Certified Public Accountant License | 2020-01-01 ~ 2020-12-31 |
| Jason M Donnelly | 32 Church St Apt #6, Lebanon, NH 03766 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Maureen Doyle Pa | 6 Cedarwood Lane, Lebanon, NH 03766 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Home Partners Inc | 3 Campbell St, Lebanon, NH 03766 | Home Improvement Contractor | 2001-12-01 ~ 2002-11-30 |
| Nancy Jean Ferguson | 85 Mechanic Street, Suite A1-1, Lebanon, NH 03766 | Physician/surgeon | ~ |
| Christina M Rooney | 4 Cedarwood Ln, Lebanon, NH 03766 | Registered Nurse | 2017-01-01 ~ 2017-12-31 |
| Find all Licenses in zip 03766 | |||
| City | LEBANON |
| Zip Code | 03766 |
| License Type | NONRESIDENT PHARMACY |
| License Type + County | NONRESIDENT PHARMACY + LEBANON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Johnson Memorial Hospital Inc. · Johnson Memorial Hospital | 201 Chestnut Hill Rd, Stafford Springs, CT 06076-4005 | General Hospital | 2014-01-01 ~ 2015-12-31 |
| Johnson Memorial Hospital, Inc. · Johnson Memorial Hospital | 201 Chestnut Hill Rd, Stafford Springs, CT 06076-4005 | General Hospital | 2020-01-01 ~ 2021-12-31 |
| Memorial Hospital for Cancer and Allied Diseases | 160 E 53rd St Room 353, New York, NY 10022 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Lawrence & Memorial Hospital | 52 Hazelnut Hill Rd, Groton, CT 06340-3268 | Certified Ems Organization | 2019-10-01 ~ 2020-09-30 |
| Lawrence + Memorial Hospital | 365 Montauk Ave, New London, CT 06320-4700 | General Hospital | 2019-04-01 ~ 2021-03-31 |
| Windham Community Memorial Hospital, Inc. and Hatch Hospital Corporation · Windham Community Memorial Hospital, Inc. | 112 Mansfield Ave, Willimantic, CT 06226-2045 | General Hospital | 2019-10-01 ~ 2021-09-30 |
| Manchester Memorial Hospital | 71 Haynes St, Manchester, CT 06040-4131 | General Hospital | 2018-10-01 ~ 2020-09-30 |
| Manchester Memorial Hospital; The · Manchester Memorial Hospital | 71 Haynes St, Manchester, CT 06040-4131 | General Hospital | 2016-01-01 ~ 2017-12-31 |
| Bradley Memorial Hospital and Health Center Inc. · Bradley Memorial Hospital and Health Center | 81 Meriden Avenue, Southington, CT 06489 | General Hospital | 2005-07-01 ~ 2007-06-30 |
| Lawrence & Memorial Hospital | 365 Montauk Ave, New London, CT 06320 | Controlled Substance Registration for Hospitals | 2019-03-01 ~ 2021-02-28 |
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| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).