340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
OUTPATIENT PHARMACY SVCS AT YALE NEW HAV
DSH070007 LAWRENCE & MEMORIAL HOSPITAL
Print
Covered Entity Details
Entity Name
LAWRENCE & MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070007
Entity Address
365 MONTAUK AVENUE
NEW LONDON, CT 06320-4700
Medicare Provider Number
070007
Participating Start Date
7/1/2019
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
OUTPATIENT PHARMACY SVCS AT YALE NEW HAV
Pharmacy Address
1100 SHERMAN AVE
C/O TERRI SUE RUBINO
HAMDEN, CT 06514
Pharmacy Comments
Contract Details
Approval Date
10/4/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/27/2018
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Seth Van Essendelft, CFO
(860) 442-0711 Ext: 2211
Contract Pharmacy Representative
YALE NEW HAVEN HOSPITAL
Sheila Talty, Manager, Specialty Pharmacy
(203) 747-7589
Signed By Date
10/4/2016
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session