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CORAM HEALTHCARE CORPORATION OF MASSACHU
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
CORAM HEALTHCARE CORPORATION OF MASSACHU
Pharmacy Address
CORAM CVS/SPECIALTY INFUSION SERVICES
575 UNIVERSITY AVENUE
SUITE 2
NORWOOD, MA 02062
Pharmacy Comments
Contract Details
Approval Date
4/17/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/17/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Michael Loftus, Vice President - Finance
(203) 200-3833
Contract Pharmacy Representative
Caremark L.L.C.
Christian reid, 340b Program Director
(401) 770-2118
Signed By Date
4/17/2017
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