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ESI MAIL PHARMACY SERVICE
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
ESI MAIL PHARMACY SERVICE
Pharmacy Address
DBA EXPRESS SCRIPTS
7909 S HARDY DR STE 106
TEMPE, AZ 85284-1112
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
12/16/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Janette Edwards, Vice President Operations, Central Region
(860) 224-5421
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/15/2019
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