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WAL-MART PHARMACY 10-5439
CH010070 CORNELL SCOTT-HILL HEALTH CORPORATION
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Covered Entity Details
Entity Name
CORNELL SCOTT-HILL HEALTH CORPORATION
Subdivision Name
CORNELL SCOTT-HILL HEALTH CORPORATION
Type
HRSA-Funded Health Center
340B ID
CH010070
Entity Address
400-428 COLUMBUS AVENUE
NEW HAVEN, CT 06519-1233
Grant Number
H80CS00312
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5439
Pharmacy Address
315 FOXON BLVD
NEW HAVEN, CT 06513
Pharmacy Comments
Contract Details
Approval Date
7/3/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vanessa E Andrews, Chief Corporate
(203) 503-3241
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
7/3/2024
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