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THE STOP & SHOP SUPERMARKT CO
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
THE STOP & SHOP SUPERMARKT CO
Pharmacy Address
DBA STOP & SHOP PHARMACY#630
44 FENN ROAD
NEWINGTON, CT 06111
Pharmacy Comments
Contract Details
Approval Date
10/16/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/23/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Julie M Drouin, VP of Finance
(860) 545-0585
Contract Pharmacy Representative
Hannaford Bros. Co., LLc
Deanne Sargent, Manager Pharmacy Network & Buisness Development
(207) 885-3044
Signed By Date
10/16/2020
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