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PROCARE PHARMACY, L.L.C.
CAH301304-00 THE NEW LONDON HOSPITAL ASSOCIATION, INC
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Covered Entity Details
Entity Name
THE NEW LONDON HOSPITAL ASSOCIATION, INC
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH301304-00
Entity Address
273 COUNTY ROAD
NEW LONDON, NH 03257
Medicare Provider Number
301304
Participating Start Date
9/20/2010
Last Recertification Date
8/14/2024
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
7/16/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Martin Thomas Manion, President and Chief Executive Officer
(603) 526-5241
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/16/2021
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