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YALE NEW HAVEN HEALTH PHARMACY
DSH070010 BRIDGEPORT HOSPITAL
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Covered Entity Details
Entity Name
BRIDGEPORT HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070010
Entity Address
267 GRANT STREET
BRIDGEPORT, CT 06610-0120
Medicare Provider Number
070010
Participating Start Date
4/1/2006
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
YALE NEW HAVEN HEALTH PHARMACY
Pharmacy Address
NORTH HAVEN MEDICAL CENTER
6 DEVINE ST
NORTH HAVEN, CT 06473
Pharmacy Comments
Contract Details
Approval Date
4/5/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Leeann Miller, Chief Pharmacy Officer
(203) 479-3000
Contract Pharmacy Representative
YNHHS
Vinay Sawant, Director Specialty Pharmacy Services
(203) 747-7899
Signed By Date
4/5/2023
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