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WALGREEN EASTERN CO., INC.
CH01006F FAIR HAVEN COMMUNITY HEALTH CLINIC INC
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Covered Entity Details
Entity Name
FAIR HAVEN COMMUNITY HEALTH CLINIC INC
Subdivision Name
Clinton Avenue School Based Health Center
Type
HRSA-Funded Health Center
340B ID
CH01006F
Entity Address
293 Clinton Ave
NEW HAVEN, CT 06513-2814
Grant Number
H80CS00741
Participating Start Date
1/1/2016
Last Recertification Date
2/15/2025
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
DBA: WALGREENS #12120
157 MAIN ST
EAST HAVEN, CT 06512
Pharmacy Comments
Contract Details
Approval Date
4/10/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
SUZANNE LAGARDE, CEO
(203) 752-5129
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/10/2024
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