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WAL-MART PHARMACY 10-2371
CH012080 COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
CHC of Middletown
Type
HRSA-Funded Health Center
340B ID
CH012080
Entity Address
675 Main St
Middletown, CT 06457
Grant Number
H80CS00326
Participating Start Date
4/1/2002
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2371
Pharmacy Address
844 NORTH COLONY RD
WALLINGFORD, CT 06492
Pharmacy Comments
Contract Details
Approval Date
7/1/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARK MASSELLI, CEO
(860) 347-6971 Ext: 3620
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
7/1/2016
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