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WEST HAVEN PHARMACY
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
WEST HAVEN PHARMACY
Pharmacy Address
764 CAMPBELL AVE STE A
WEST HAVEN, CT 06516-3786
Pharmacy Comments
Contract Details
Approval Date
1/15/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MICHAEL R. TAYLOR, CEO
(203) 503-3274
Contract Pharmacy Representative
West Haven Pharmacy
chandra vipparla, member
(203) 522-1893
Signed By Date
1/15/2018
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