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PROCARE PHARMACY, L.L.C.
DSH070003 Day Kimball Hospital
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Covered Entity Details
Entity Name
Day Kimball Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070003
Entity Address
320 Pomfret Street
Putnam, CT 06260-1869
Medicare Provider Number
070003
Participating Start Date
7/1/2013
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2923
3250 HARDEN ST. EXT. SUITE #300
COLUMBIA, SC 29203
Pharmacy Comments
Contract Details
Approval Date
7/1/2020
Contract Begin Date
7/10/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul A. Beaudoin, Chief Financial Officer
(860) 928-6541 Ext: 2113
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/1/2020
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