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CH01241F STAYWELL HEALTH CARE, INC. (Terminated)
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Main Details
Name
STAYWELL HEALTH CARE, INC.
Subdivision Name
Wallace School Based Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-013964
340B ID
CH01241F
Grant Number
H80CS00350
Additional Details
Current Program Status
Terminated
Registration Date
3/16/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/16/2015
Last Recertification Date
2/16/2023
Termination Date
Termination Reason
4/1/2024
Other
Contacts
Authorizing Official
StayWell Health Care Inc.
Donald Thompson, CEO
(203) 756-8021 Ext: 3016
Primary Contact
StayWell Health Care Inc.
Donna DeRosa, Executive Assistant
(203) 756-8021 Ext: 3013
Addresses
Street Address
3465 E Main St
Waterbury, CT 06705-3815
Billing Address
StayWell Health Care, Inc.
80 Phoenix Avenue
Suite 201
Waterbury, CT 06702
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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