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WAL-MART PHARMACY 10-3803
CH010070 CORNELL SCOTT-HILL HEALTH CORPORATION
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Covered Entity Details
Entity Name
CORNELL SCOTT-HILL HEALTH CORPORATION
Subdivision Name
CORNELL SCOTT-HILL HEALTH CORPORATION
Type
HRSA-Funded Health Center
340B ID
CH010070
Entity Address
400-428 COLUMBUS AVENUE
NEW HAVEN, CT 06519-1233
Grant Number
H80CS00312
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-3803
Pharmacy Address
515 SAWMILL ROAD
WEST HAVEN, CT 06516
Pharmacy Comments
Contract Details
Approval Date
10/13/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MICHAEL R. TAYLOR, CEO
(203) 503-3274
Contract Pharmacy Representative
Healdsburg District Hospital
Kathi Phelps, Manager Contracting
(479) 277-3719
Signed By Date
10/13/2017
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