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BRASS MILL 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
BRASS MILL PHARMACY
Pharmacy Address
DBA PARK PHARMACY
1527 E MAIN ST
WATERBURY, CT 06705-1081
Pharmacy Comments
Contract Details
Approval Date
4/5/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/20/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Donald Thompson, CEO
(203) 756-8021 Ext: 3016
Contract Pharmacy Representative
JALPA PATEL, OWNER
(203) 721-8022
Signed By Date
4/5/2017
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