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THE PRICE CHOPPER INC.
DSH070003 Day Kimball Hospital
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Covered Entity Details
Entity Name
Day Kimball Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070003
Entity Address
320 Pomfret Street
Putnam, CT 06260-1869
Medicare Provider Number
070003
Participating Start Date
7/1/2013
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
THE PRICE CHOPPER INC.
Pharmacy Address
PRICE CHOPPER PHARMACY #189
251 KENNEDY DRIVE SUITE A
PUTNAM, CT 06260
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paul A. Beaudoin, Chief Financial Officer
(860) 928-6541 Ext: 2113
Contract Pharmacy Representative
Northeast Shared Services
Scott Guisinger, Vice President of Pharmacy
(518) 379-2409
Signed By Date
1/16/2024
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