Contract Pharmacy Details

HARTFORD PHARMACY
CH013370 First Choice Health Centers, Inc.

Covered Entity Details

Entity Name

First Choice Health Centers, Inc.

Subdivision Name

First Choice Health Centers, Inc

Type

HRSA-Funded Health Center

340B ID

CH013370

Entity Address

94 Connecticut Blvd
East Hartford, CT 06108-3013

Grant Number

H80CS00262

Participating Start Date

4/1/2001

Last Recertification Date

2/25/2025

Pharmacy Details

Pharmacy Name

HARTFORD PHARMACY

Pharmacy Address

531 PARK ST
HARTFORD, CT 06106

Pharmacy Comments

Contract Details

Approval Date

7/29/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/13/2017
Agreement registered in error

Contacts

Covered Entity Signing Official

Eugene Market, President & CEO
(860) 610-6131

Contract Pharmacy Representative

Hartford Pharmacy
Pravin Dhulipalla, Owner
(860) 289-0000

Signed By Date

7/29/2016

340B Drug Pricing Program Database