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HARTFORD HOSPITAL
RWI06030 University of Connecticut Health Center
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Covered Entity Details
Entity Name
University of Connecticut Health Center
Subdivision Name
Division of Infectious Diseases / Infectious Diseases Clinic
Type
Ryan White Part A
340B ID
RWI06030
Entity Address
263 Farmington Avenue
Farmington, CT 06030-3212
Grant Number
H89HA00044
Participating Start Date
1/1/2012
Last Recertification Date
3/2/2025
Pharmacy Details
Pharmacy Name
HARTFORD HOSPITAL
Pharmacy Address
DBA HARTFORD HEALTHCARE RETAIL PHARMACY
85 SEYMOUR ST STE 105
HARTFORD, CT 06106
Pharmacy Comments
Contract Details
Approval Date
4/3/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kimberly Metcalf, AVP Pharmacy and Ancillary Services
(860) 679-7943
Contract Pharmacy Representative
Hartford Hospital
Eric Arlia, Director of Pharmacy
(860) 972-4165
Signed By Date
4/3/2020
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