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OPTION CARE ENTERPRISES, INC.
DSH070025 HARTFORD HOSPITAL
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Covered Entity Details
Entity Name
HARTFORD HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070025
Entity Address
80 SEYMOUR STREET
HARTFORD, CT 06102
Medicare Provider Number
070025
Participating Start Date
7/1/2016
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
OPTION CARE ENTERPRISES, INC.
Pharmacy Address
D/B/A OPTION CARE
11403 BLUEGRASS PARKWAY
SUITE 400
LOUISVILLE, KY 40299-2398
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gerald Boisvert, Vice President, Finance Operations
(860) 545-0585
Contract Pharmacy Representative
Option Care Health
Jennifer Money, Manager, Health Systems Programs
(312) 940-2504
Signed By Date
4/15/2020
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