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CONNECTICUT CVS PHARMACY, L.L.C.
CHC29000-06 UNITED COMMUNITY SERVICES INC
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Covered Entity Details
Entity Name
UNITED COMMUNITY SERVICES INC
Subdivision Name
UCFS at Waterford Country School
Type
HRSA-Funded Health Center
340B ID
CHC29000-06
Entity Address
78 Hunts Brook Rd
Quaker Hill, CT 06375-1009
Grant Number
H80CS29000
Participating Start Date
1/1/2016
Last Recertification Date
2/21/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
CONNECTICUT CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 556
1657 ROUTE 12
GALES FERRY, CT 06335
Pharmacy Comments
Contract Details
Approval Date
4/14/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Jennifer Granger, President/CEO
(860) 822-4143
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2022
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