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CONNECTICUT CVS PHARMACY, L.L.C.
RRC070011-00 CHARLOTTE HUNGERFORD HOSPITAL
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Covered Entity Details
Entity Name
CHARLOTTE HUNGERFORD HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC070011-00
Entity Address
540 LITCHFIELD STREET
TORRINGTON, CT 06790-0988
Medicare Provider Number
070011
Participating Start Date
4/1/2024
Last Recertification Date
9/3/2024
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
CONNECTICUT CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01180
358 W. MAIN ST,
AVON, CT 06001
Pharmacy Comments
Contract Details
Approval Date
4/12/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Sean Michael Curtin, Vice President, Finance, Hartford Region
(860) 545-0585
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/12/2024
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