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CONNECTICUT CVS PHARMACY, L.L.C.
DSH070035 The Hospital of Central Connecticut
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Covered Entity Details
Entity Name
The Hospital of Central Connecticut
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070035
Entity Address
100 Grand St.
New Britain, CT 06052
Medicare Provider Number
070035
Participating Start Date
7/1/2013
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
CONNECTICUT CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01060
326 MAIN STREET
SOUTHINGTON, CT 06489
Pharmacy Comments
Contract Details
Approval Date
10/19/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Janette Edwards, Vice President Operations, Central Region
(860) 224-5421
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/19/2018
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