VERMONT SUPPLEMENTAL DRUG-REBATE AGREEMENTVermont Supplemental Drug-Rebate Agreement • May 5th, 2020
This Agreement is entered into by the following parties on the date last signed below:Vermont Supplemental Drug-Rebate Agreement • March 22nd, 2024
Pharmaceutical Manufacturer ("Manufacturer") Department of Vermont Health Access ("The State") Labeler Codes: Department of Vermont Health Access Manufacturer Primary Billing Address: State Primary Billing Address: Change Healthcare, Vermont RebateP.O. Box 1038Augusta, ME 04332-1038 Manufacturer Primary Contact Person: State Primary Contact Person: Shari Martin Manufacturer Primary Contact Telephone: State Primary Contact Telephone: 207-622-7153 x71375 Manufacturer Primary Contact e-mail: State Primary Contact e-mail: PBA_srcontracts@changehealthcare.com Address for Notices required by Agreement("Manufacturer Notice Address"): Address for Notices required by Agreement: ("StateNotice Address"): State of VermontDepartment of Vermont Health Access Pharmacy Unit - Stacey Baker280 State Drive, NOB1 SouthSouth Waterbury, VT 05671 Termination Date: ("Termination Date") Effective Date ("Effective Date") 12/31/2025 01/01/2025
This Agreement is entered into by the following parties on the date last signed below:Vermont Supplemental Drug-Rebate Agreement • January 7th, 2020
Pharmaceutical Manufacturer (“Manufacturer”) Department of Vermont Health Access (“The State”) Labeler Code: Manufacturer Primary Billing Address: State Primary Billing Address: Manufacturer Primary Contact Person: State Primary Contact Person: Manufacturer Primary Contact Telephone: State Primary Contact Telephone: Manufacturer Primary Contact e-mail: State Primary Contact e-mail: Address for Notices required by Agreement (“Manufacturer Notice Address”): Address for Notices required by Agreement: (“State Notice Address”): State of VermontDepartment of Vermont Health Access Pharmacy Unit-Stacey Baker280 State Drive, NOB1 South South Waterbury, VT 05671 Termination Date: (“Termination Date”) Effective Date (“Effective Date”)
VERMONT SUPPLEMENTAL DRUG REBATE AGREEMENTVermont Supplemental Drug Rebate Agreement • May 5th, 2020
