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CONNECTICUT CVS PHARMACY, L.L.C.
CH01241J STAYWELL HEALTH CARE, INC.
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Covered Entity Details
Entity Name
STAYWELL HEALTH CARE, INC.
Subdivision Name
StayWell Health Center at St. V's
Type
HRSA-Funded Health Center
340B ID
CH01241J
Entity Address
114 Benedict St
Waterbury, CT 06706-1007
Grant Number
H80CS00350
Participating Start Date
1/1/2017
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
CONNECTICUT CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01244
26 WATERBURY ROAD
PROSPECT, CT 06712
Pharmacy Comments
Contract Details
Approval Date
1/9/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Donald Thompson, CEO
(203) 756-8021 Ext: 3016
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/9/2019
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