Contract Pharmacy Details

CVS MANCHESTER NH, L.L.C.
CAH301304-00 THE NEW LONDON HOSPITAL ASSOCIATION, INC

Covered Entity Details

Entity Name

THE NEW LONDON HOSPITAL ASSOCIATION, INC

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH301304-00

Entity Address

273 COUNTY ROAD
NEW LONDON, NH 03257

Medicare Provider Number

301304

Participating Start Date

9/20/2010

Last Recertification Date

8/14/2024

Pharmacy Details

Pharmacy Name

CVS MANCHESTER NH, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 07391
861 CENTRAL ST.
FRANKLIN, NH 03235

Pharmacy Comments

Contract Details

Approval Date

1/9/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Bruce King, Chief Executive Officer
(603) 526-5512

Contract Pharmacy Representative

CVS
Christian Reid, 340B Program Director, CVS Pharmacy
(401) 770-2118

Signed By Date

1/9/2020

340B Drug Pricing Program Database