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CONNECTICUT CVS PHARMACY, L.L.C.
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
CONNECTICUT CVS PHARMACY, L.L.C.
Pharmacy Address
CVS PHARMACY # 17238
300 CHASE AVE
WATERBURY, CT 06704
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Donald Thompson, CEO
(203) 756-8021 Ext: 3016
Contract Pharmacy Representative
CVS
Christian Reid, 340B Program Director, CVS Pharmacy
(401) 770-2118
Signed By Date
1/13/2020
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