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GRAND ST. PAUL CVS, L.L.C.
RWI06030 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
RWI06030
Entity Address
263 Farmington Avenue
Farmington, CT 06030-3212
Grant Number
H89HA00044
Participating Start Date
1/1/2012
Last Recertification Date
3/2/2025
Pharmacy Details
Pharmacy Name
GRAND ST. PAUL CVS, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 5788
6905 YORK AVENUE
EDINA, MN 55435
Pharmacy Comments
Contract Details
Approval Date
10/19/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kimberly Metcalf, AVP Pharmacy and Ancillary Services
(860) 679-7943
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/19/2021
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