Contract Pharmacy Details

PHYSICIANS RX PHARMACY OF CLINTON, INC.
RWI06106 Advancing Connecticut Together, Inc.

Covered Entity Details

Entity Name

Advancing Connecticut Together, Inc.

Subdivision Name

Main Office

Type

Ryan White Part A

340B ID

RWI06106

Entity Address

110 Bartholomew Avenue, Suite 3050
Hartford, CT 06106

Grant Number

H89HA00044

Participating Start Date

10/1/2016

Last Recertification Date

2/7/2024

Entity Termination Date

7/1/2024

Pharmacy Details

Pharmacy Name

PHYSICIANS RX PHARMACY OF CLINTON, INC.

Pharmacy Address

PHYSICIANS RX PHARMACY CLINTON
9131 PISCATAWAY ROAD
SUITE 670
CLINTON, MD 20735

Pharmacy Comments

Contract Details

Approval Date

7/22/2016

Contract Begin Date

10/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/3/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Donald R. Smith, CEO
(412) 357-5163

Signed By Date

340B Drug Pricing Program Database