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CH01241L Staywell Health Care, Inc. (Terminated)
Main Details
Name
Staywell Health Care, Inc.
Subdivision Name
Wilby School-Based Health Center
Type
HRSA-Funded Health Center
Site ID
BPS-H80-017092
340B ID
CH01241L
Grant Number
H80CS00350
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
Additional Details
Current Program Status
Terminated
Registration Date
4/9/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/15/2019
Last Recertification Date
2/16/2023
Termination Date
4/1/2024
Termination Reason
Other
Addresses
Street Address
568 Bucks Hill Road
Waterbury, CT 06704-0670
Billing Address
StayWell Health Center
80 Phoenix Ave.
201
Waterbury, CT 06702-1418
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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