Contract Pharmacy Details

CVS MANCHESTER NH, L.L.C.
CAH301304-00 THE NEW LONDON HOSPITAL ASSOCIATION, INC

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

CVS MANCHESTER NH, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 00741
66 SOUTH RIVER RD.
BEDFORD, NH 03110

Pharmacy Comments

Contract Details

Approval Date

10/5/2021

Contract Begin Date

10/21/2021

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

10/5/2021

340B Drug Pricing Program Database