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UCONN HEALTH PHARMACY SERVICES INC.
RWI06030B University of Connecticut Health Center
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Covered Entity Details
Entity Name
University of Connecticut Health Center
Subdivision Name
Division of Infectious Diseases/Infectious Diseases Clinic
Type
Ryan White Part A
340B ID
RWI06030B
Entity Address
65 Kane Street
West Hartford, CT 06119
Grant Number
H89HA00044
Participating Start Date
10/1/2021
Last Recertification Date
2/3/2022
Entity Termination Date
10/1/2022
Pharmacy Details
Pharmacy Name
UCONN HEALTH PHARMACY SERVICES INC.
Pharmacy Address
270 FARMINGTON AVE STE 108
FARMINGTON, CT 06032
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kimberly Metcalf, AVP Pharmacy and Ancillary Services
(860) 679-7943
Contract Pharmacy Representative
UConn Health
Kimberly Metcalf, AVP Pharmacy and Ancillary Services
(860) 679-7943
Signed By Date
10/15/2021
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