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BUNKER HILL PHARMACY
CH01241E STAYWELL HEALTH CARE, INC.
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Covered Entity Details
Entity Name
STAYWELL HEALTH CARE, INC.
Subdivision Name
StayWell Health Center
Type
HRSA-Funded Health Center
340B ID
CH01241E
Entity Address
402 E MAIN ST
WATERBURY, CT 06702-1701
Grant Number
H80CS00350
Participating Start Date
4/1/2015
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
BUNKER HILL PHARMACY
Pharmacy Address
256 BUNKER HILL AVE
WATERBURY, CT 06708
Pharmacy Comments
Contract Details
Approval Date
3/12/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Bunker Hill Pharmacy
WILLIAM SUMMA, PRESIDENT
(203) 574-7825
Signed By Date
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