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BRIDGEPORT CHEMISTS
CH01081A Southwest Community Health Center, Inc.
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Covered Entity Details
Entity Name
Southwest Community Health Center, Inc.
Subdivision Name
SOUTHWEST COMMUNITY HLTH CTR, INC
Type
HRSA-Funded Health Center
340B ID
CH01081A
Entity Address
743 South Ave
Bridgeport, CT 06604-5810
Grant Number
H80CS00613
Participating Start Date
4/11/2019
Last Recertification Date
1/28/2020
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
BRIDGEPORT CHEMISTS
Pharmacy Address
DBA HANCOCK PHARMACY
1407 FAIRFIELD AVENUE
BRIDGEPORT, CT 06605
Pharmacy Comments
Contract Details
Approval Date
10/20/2011
Contract Begin Date
12/14/2005
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
11/4/2005
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