Contract Pharmacy Details

THE STOP & SHOP SUPERMARKT CO
RRC070028-00 ST. VINCENTS MEDICAL CENTER

Covered Entity Details

Entity Name

ST. VINCENTS MEDICAL CENTER

Subdivision Name

Type

Rural Referral Center

340B ID

RRC070028-00

Entity Address

2800 MAIN STREET
BRIDGEPORT, CT 06606-4201

Medicare Provider Number

070028

Participating Start Date

10/8/2021

Last Recertification Date

9/19/2022

Entity Termination Date

1/13/2023

Pharmacy Details

Pharmacy Name

THE STOP & SHOP SUPERMARKT CO

Pharmacy Address

DBA STOP & SHOP PHARMACY #670
4531 MAIN STREET
BRIDGEPORT, CT 06606-1846

Pharmacy Comments

Contract Details

Approval Date

1/13/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/13/2023
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Christopher Given, VP, Finance
(475) 210-6193

Contract Pharmacy Representative

Stop and Shop
David Dunn, Pharmacy Operations Manager
(774) 644-1263

Signed By Date

1/13/2022

340B Drug Pricing Program Database