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YALE NEW HAVEN HEALTH PHARMACY BRIDGEPOR
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 BRIDGEPOR
Pharmacy Address
267 GRANT ST
BRIDGEPORT, CT 06610
Pharmacy Comments
Contract Details
Approval Date
10/11/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Leeann Miller, Chief Pharmacy Officer
(203) 479-3000
Contract Pharmacy Representative
YNHHS
Vinay Sawant, Director Specialty Pharmacy Services
(203) 747-7899
Signed By Date
10/11/2024
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