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APOTHECARY & WELLNESS CENTER
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
APOTHECARY & WELLNESS CENTER
Pharmacy Address
1450 CHAPEL STREET
NEW HAVEN, CT 06511-4405
Pharmacy Comments
Contract Details
Approval Date
7/28/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JAMES M. STATEN, SENIOR VP FINANCE
(203) 688-2603
Contract Pharmacy Representative
Yale New Haven Health System
Marjorie Lazarre, Director, Pharmaceutical Procurement and Business Practices
(203) 688-7105
Signed By Date
7/28/2014
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