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CONNECTICUT CVS PHARMACY, L.L.C.
CH01081F Southwest Community Health Center, Inc.
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Covered Entity Details
Entity Name
Southwest Community Health Center, Inc.
Subdivision Name
Casa Recovery
Type
HRSA-Funded Health Center
340B ID
CH01081F
Entity Address
1124 Iranistan Ave
Bridgeport, CT 06605-1121
Grant Number
H80CS00613
Participating Start Date
4/11/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CONNECTICUT CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01153
1875 BOSTON AVE, CVS PLAZA
BRIDGEPORT, CT 06610
Pharmacy Comments
Contract Details
Approval Date
4/3/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mollie Melbourne, President/CEO
(203) 332-3501
Contract Pharmacy Representative
CVS Health
Christian Reid, Sr. Director 340B
(401) 770-2118
Signed By Date
4/3/2024
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