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YALE NEW HAVEN HEALTH PHARMACY
DSH070022 YALE NEW HAVEN HOSPITAL
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Covered Entity Details
Entity Name
YALE NEW HAVEN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070022
Entity Address
20 York Street
New Haven, CT 06510
Medicare Provider Number
070022
Participating Start Date
7/1/2004
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
YALE NEW HAVEN HEALTH PHARMACY
Pharmacy Address
LAWRENCE + MEMORIAL HOSPITAL
365 MONTAUK AVE
OUTPATIENT PHARMACY
NEW LONDON, CT 06320
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
Leeann Miller, Chief Pharmacy Officer
(203) 479-3000
Contract Pharmacy Representative
Lawrence and Memorial Hospital
Mark Rogers, Director of Pharmacy
(860) 271-4914
Signed By Date
4/15/2024
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