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RRC070011-07 CHARLOTTE HUNGERFORD HOSPITAL (Terminated)
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Main Details
Name
CHARLOTTE HUNGERFORD HOSPITAL
Subdivision Name
CH NUTRITION THOM - Nutrition
Type
Rural Referral Center
Rural
Yes
340B ID
RRC070011-07
Medicare Provider Number
070011
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/14/2024
Last Recertification Date
9/3/2024
Termination Date
Termination Reason
4/1/2025
Change of covered entity type
Contacts
Authorizing Official
Hartford HealthCare
Cheryl Considine, Director Finance, NW Region
(860) 496-6740
Primary Contact
Hartford Healthcare
Elyse A Sweeney, System 340B Program Manager
(860) 972-5030
Addresses
Street Address
76 Watertown Road
Thomaston, CT 06787
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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