Contract Pharmacy Details

CONNECTICUT CVS PHARMACY, L.L.C.
DSH070035 The Hospital of Central Connecticut

Covered Entity Details

Entity Name

The Hospital of Central Connecticut

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH070035

Entity Address

100 Grand St.
New Britain, CT 06052

Medicare Provider Number

070035

Participating Start Date

7/1/2013

Last Recertification Date

8/27/2024

Pharmacy Details

Pharmacy Name

CONNECTICUT CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 01060
326 MAIN STREET
SOUTHINGTON, CT 06489

Pharmacy Comments

Contract Details

Approval Date

4/18/2014

Contract Begin Date

7/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2016
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Steven D. Hanks, Executive VP & Chief Medical Officer
(860) 224-5554

Contract Pharmacy Representative

CVS Caremark
Anthony Gratto, 340B Vendor Manager
(401) 770-7298

Signed By Date

4/18/2014

340B Drug Pricing Program Database