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NAUGATUCK PHARMACY
CH01241K Staywell Health Care, Inc.
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Covered Entity Details
Entity Name
Staywell Health Care, Inc.
Subdivision Name
StayWell Health Center at Western CT Mental Health Network
Type
HRSA-Funded Health Center
340B ID
CH01241K
Entity Address
95 Thomaston Ave
Waterbury, CT 06702-1007
Grant Number
H80CS00350
Participating Start Date
1/1/2018
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
NAUGATUCK PHARMACY
Pharmacy Address
153 MAPLE ST
NAUGATUCK, CT 06770-4256
Pharmacy Comments
Contract Details
Approval Date
4/15/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/11/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Donald Thompson, CEO
(203) 756-8021 Ext: 3016
Contract Pharmacy Representative
Naugatuck Pharmacy
Sanjay Patel, President
(203) 632-8380
Signed By Date
4/15/2019
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