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CONNECTICUT CVS PHARMACY, L.L.C.
DSH070002 Saint Francis Hospital and Medical Center
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Covered Entity Details
Entity Name
Saint Francis Hospital and Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070002
Entity Address
114 Woodland Street
Hartford, CT 06105
Medicare Provider Number
070002
Participating Start Date
7/1/2012
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
CONNECTICUT CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01910
260 NORTH MAIN STREET
MANCHESTER, CT 06042
Pharmacy Comments
Contract Details
Approval Date
10/14/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/8/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Jennifer S Schneider, SVP and Chief Financial Officer
(860) 714-5360
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/14/2021
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