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WAL-MART PHARMACY 10-2200
CH01208BE COMMUNITY HEALTH CENTER, INCORPORATED
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTER, INCORPORATED
Subdivision Name
Marine Science Magnet High School SBHC
Type
HRSA-Funded Health Center
340B ID
CH01208BE
Entity Address
130 Shennecossett Rd
Groton, CT 06340-5117
Grant Number
H80CS00326
Participating Start Date
7/1/2013
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-2200
Pharmacy Address
150 GOLD STAR HWY
GROTON, CT 06340
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark Masselli, President and CEO
(860) 347-6971
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
4/15/2024
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