340B Drug Pricing Program Database


DSH220086DY BETH ISRAEL DEACONESS MEDICAL CENTER (Active) - information as of 5/2/2025 10:34:05 PM

Main Details
BETH ISRAEL DEACONESS MEDICAL CENTER
BETH ISRAEL DEACONESS MEDICAL CENTE - HEMONC INFUSION
Disproportionate Share Hospital
Yes
DSH220086DY
220086


Additional Details
Active
1/13/2025
4/1/2025
1/27/2025

Contacts

BIDMC
Matthew Larkin, Chief Operating Officer
(617) 677-7144

Lahey
Laura Emilee Murphy, 340B Program Manager
(978) 922-3000 Ext: 3625

Addresses

330 BROOKLINE AVE
BOSTON, MA 02215-5400

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
MA110000014C,110000014D1548202641
Shipping Addresses

Same as Street Address
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH220086AChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBOWDOIN STREET HEALTH CENTER230 BOWDOIN ST.DORCHESTERMATerminated
DSH220086AAChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - INFECTIOUS DISEASE CLINIC110 FRANCIS STREETBOSTONMAActive
DSH220086ABChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - CARDIAC SURGERY CLINIC110 FRANCIS STREETBOSTONMAActive
DSH220086ACChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - ORTHOPEDICS CLINIC482 Bedford St.LEXINGTONMAActive
DSH220086ADChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - PHYSICAL THERAPY SERVICES482 BEDFORD STREETLEXINGTONMAActive
DSH220086AEChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - OCCUPATIONAL THERAPY SERVICES482 BEDFORD STREETLEXINGTONMAActive
DSH220086AFChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBOWDOIN STREET HEALTH CENTER - PHYSICAL THERAPY230 BOWDOIN STREETDORCHESTERMAActive
DSH220086AGChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - OB/GYN CLINIC1000 BROADWAY STREETCHELSEAMAActive
DSH220086AHChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - OPTOMETRY SERVICES482 BEDFORD STREETLEXINGTONMAActive
DSH220086AJChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBOWDOIN STREET HEALTH CENTER - PODIATRY CLINIC230 BOWDOIN STREETDORCHESTERMATerminated
DSH220086AKChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - RADIOLOGY SERVICES1000 BROADWAY STREETCHELSEAMAActive
DSH220086ALChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - PHYSICAL THERAPY1000 BROADWAY STREETCHELSEAMAActive
DSH220086AMChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - ADULT MEDICINE CLINIC1000 BROADWAY STREETCHELSEAMAActive
DSH220086ANChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - URGENT CARE - CHELSEA1000 BROADWAY STREETCHELSEAMAActive
DSH220086APChildDSHBETH ISRAEL DEACONESS MEDICAL CENTEROne Bookline Place - GERONTOLOGY CLINICOne Brookline PlaceBrooklineMAActive
DSH220086AQChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - LAB SERVICES482 BEDFORD STREETLEXINGTONMATerminated
DSH220086ARChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - LABORATORY SERVICES1000 BROADWAY STREETCHELSEAMATerminated
DSH220086ASChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - OPTOMETRY CLINIC1000 BROADWAY STREETCHELSEAMAActive
DSH220086ATChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - PFT CLINIC1000 BROADWAY STREETCHELSEAMAActive
DSH220086AUChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - NEUROSURGERY CLINIC110 FRANCIS STREETBostonMAActive
DSH220086AVChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - MEDICINE SPECIALTY CLINIC482 BEDFORD STREETLEXINGTONMAActive
DSH220086AWChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - ADULT SPECIALTY CLINIC1000 BROADWAY STREETCHELSEAMAActive
DSH220086AXChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - ENDOSCOPY SERVICES482 BEDFORD STREETLEXINGTONMAActive
DSH220086AYChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - ALLERGY CLINIC482 BEDFORD STREETLEXINGTONMAActive
DSH220086AZChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - TRANSPLANT CLINIC110 FRANCIS STREETBOSTONMAActive
DSH220086BChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH1000 BROADWAYCHELSEAMATerminated
DSH220086BAChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - GENERAL SURGERY CLINIC110 FRANCIS STREETBOSTONMAActive
DSH220086BBChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - DERMATOLOGY CLINIC482 BEDFORD STREETLEXINGTONMATerminated
DSH220086BCChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - NEUROLOGY CLINIC482 BEDFORD STREETLEXINGTONMAActive
DSH220086BDChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - PODIATRY CLINIC482 BEDFORD STREETLEXINGTONMAActive
DSH220086BEChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBOWDOIN STREET HEALTH CENTER - MEDICINE230 BOWDOIN STDORCHESTERMAActive
DSH220086BFChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - DERMATOLOGY CLINIC1000 BROADWAY STREETCHELSEAMAActive
DSH220086BGChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - MEDICINE ALLERGY CLINIC110 FRANCIS STREETBOSTONMAActive
DSH220086BHChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - OTOLARYNGOLOGY CLINIC110 FRANCIS STREETBOSTONMATerminated
DSH220086BJChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - VASCULAR LAB110 FRANCIS STREETBOSTONMAActive
DSH220086BKChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - OB/GYN CLINIC482 BEDFORD STREETLEXINGTONMAActive
DSH220086BLChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - PFT CLINIC482 BEDFORD STREETLEXINGTONMAActive
DSH220086BMChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBOWDOIN STREET HEALTH CLINIC - PSYCHIATRY CLINIC230 BOWDOIN STREETDORCHESTERMAActive
DSH220086BNChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - PLASTIC SURGERY CLINIC110 FRANCIS STREETBOSTONMATerminated
DSH220086BPChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - LIVER CLINIC110 FRANCIS STREETBOSTONMAActive
DSH220086BQChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - SURGERY CLINIC482 BEDFORD STREETLEXINGTONMAActive
DSH220086BRChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - BREAST IMAGING CENTER482 BEDFORD STREETLEXINGTONMAActive
DSH220086BSChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - RHEUMATOLOGY CLINIC110 FRANCIS STREETBOSTONMAActive
DSH220086BTChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - INFUSION CENTER482 BEDFORD STREETLEXINGTONMAActive
DSH220086BUChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - ULTRASOUND SERVICES482 BEDFORD STREETLEXINGTONMAActive
DSH220086BVChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBOWDOIN STREET HEALTH CENTER - PEDIATRIC CLINIC230 BOWDOIN STREETDORCHESTERMAActive
DSH220086BWChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - VOICE,SPEECH,SWALLOW1 Deaconess RdBostonMAActive
DSH220086BXChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - HOLTER LAB1 Deaconess RdBostonMAActive
DSH220086BYChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - RADIOLOGY MRI1 Deaconess RdBostonMAActive
DSH220086BZChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - CDAC Outpatient1 Deaconess RdBostonMAActive
DSH220086CChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON482 BEDFORD STREETLEXINGTONMATerminated
DSH220086CAChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - Thoracic Clinic1 Deaconess RdBostonMAActive
DSH220086CBChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - ANESTHESIA1 Deaconess RdBostonMATerminated
DSH220086CCChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - EXERCISE LAB1 Deaconess RdBostonMAActive
DSH220086CDChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - RAD NEUROINTERV1 Deaconess RdBostonMAActive
DSH220086CEChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - West Specialty Clinic WSC1 Deaconess RdBostonMAActive
DSH220086CFChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - Radiology Nursing1 Deaconess RdBostonMAActive
DSH220086CGChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - PACU/SDS-West1 Deaconess RdBostonMAActive
DSH220086CHChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - RAD ANGIOGRAPHY1 Deaconess RdBostonMAActive
DSH220086CJChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - RADIOLOGY CAT SCAN1 Deaconess RdBostonMAActive
DSH220086CKChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - Pancreas Multidisciplinary Clinic1 Deaconess RdBostonMATerminated
DSH220086CLChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - EEG LAB1 Deaconess RdBostonMAActive
DSH220086CMChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - CARDIAC CATH LAB1 Deaconess RdBostonMAActive
DSH220086CNChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - VENOUS ACCESS TEAM1 Deaconess RdBostonMATerminated
DSH220086CPChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - Psych Clinic1 Deaconess RdBostonMATerminated
DSH220086CQChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - Emergency Unit1 Deaconess RdBostonMAActive
DSH220086CRChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - Gerontology Clinic1 Deaconess RdBostonMATerminated
DSH220086CSChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - PODIATRY-West1 Deaconess RdBostonMAActive
DSH220086CTChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - ELECTROPHYSIOLOGY UNIT1 Deaconess RdBostonMAActive
DSH220086CUChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - RADIOLOGY GENERAL DIAGNOSTICS1 Deaconess RdBostonMAActive
DSH220086CVChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - Wound/Ostomy Clinic1 Deaconess RdBostonMATerminated
DSH220086CWChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - WEST PROCEDURAL CENTER1 Deaconess RdBostonMAActive
DSH220086CXChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - BLOOD BANK1 Deaconess RdBostonMATerminated
DSH220086CYChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - Nephrology Clinic1 Deaconess RdBostonMAActive
DSH220086CZChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - RADIOLOGY ULTRASOUND1 Deaconess RdBostonMAActive
DSH220086DChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERWest CampusONE DEACONESS ROADBOSTONMATerminated
DSH220086DAChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - ECHO LAB1 Deaconess RdBostonMAActive
DSH220086DBChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - Radiology Nuclear Medicine1 Deaconess RdBostonMATerminated
DSH220086DCChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - AUTONOMIC LAB1 Deaconess RdBostonMAActive
DSH220086DDChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - OR-West1 Deaconess RdBostonMAActive
DSH220086DEChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - REHAB (PT/OT)1 Deaconess RdBostonMAActive
DSH220086DFChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - ECT SB1 Deaconess RdBostonMAActive
DSH220086DGChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERGASTROENTEROLOGY - WEST - GI Clinic110 Francis StBostonMAActive
DSH220086DHChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERDEVICES CLINIC - Device RemoteOne Deaconess RoadBostonMAActive
DSH220086DJChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERSurgical Associates LMOB NP - Surgical Associates LMOB NP110 Francis StBostonMAActive
DSH220086DKChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBIDMC INFUSION SERVICES AT LAHEY HO - BIDMC Infusion Services at LHMC-Burlington41 MALL RDBURLINGTONMAActive
DSH220086DLChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBIDMC INFUSION SERVICES AT LAHEY PE - BIDMC Infusion Services at LHMC-Peabody1 ESSEX CENTER DRPEABODYMAActive
DSH220086DMChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Medical Center - Prophylactic MAB Clinic1 Deaconess RdBostonMATerminated
DSH220086DNChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess Healthcare - Chestnut Hill - Optometry200 Boylston StreetNewtonMAActive
DSH220086DPChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERKlarman - BIDMC Pre-OP - West111 Francis St.BostonMAActive
DSH220086DQChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERKlarman - Cardiac Intermediate Care111 Francis St.BostonMAActive
DSH220086DRChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERKlarman - Cardiothoracic surgery111 Francis St.BostonMAActive
DSH220086DSChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERThe Cancer Center at Beth Israel Deaconess Medical Center - Physical Therapy148 Chestnut St.NeedhamMAActive
DSH220086DTChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERKlarman - Cardiac medicine111 Francis St.BostonMAActive
DSH220086DUChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERJoslin - Diabetes1 Joslin PlBostonMAActive
DSH220086DVChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERFeldberg - Intravenous therapy330 Brookline Ave.BostonMAActive
DSH220086DWChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBIDMC West Campus - Crisis Stabilization UnitOne Deaconess RoadBostonMAActive
DSH220086DXChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBIDMC Winchester HemOnc620 Washington StreetWinchesterMAActive
DSH220086DYChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBETH ISRAEL DEACONESS MEDICAL CENTE - HEMONC INFUSION330 BROOKLINE AVEBOSTONMAActive
DSH220086EChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERARNOLD PAIN MANAGEMENT CENTERONE BROOKLINE PLACEBROOKLINEMAActive
DSH220086FChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess HealthCare - Chestnut Hill / Lab Services at Chestnut Hill200 Boylston StreetNewtonMATerminated
DSH220086GChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERThe Cancer Center at Beth Israel Deaconess Medical Center - Needham / Hem/Onc - BID Cancer Center Needham148 Chestnut StNeedhamMAActive
DSH220086HChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess HealthCare - Chestnut Hill / Urgent Care200 Boylston StreetNewtonMAActive
DSH220086JChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess HealthCare - Chestnut Hill / Outpatient Rehab at Chestnut Hill200 Boylston StreetNewtonMAActive
DSH220086KChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess HealthCare - Chestnut Hill / Radiology at Chestnut Hill Square200 Boylston StreetNewtonMAActive
DSH220086LChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess HealthCare - Chestnut Hill / Med/Surg Specialty200 Boylston StreetNewtonMAActive
DSH220086MChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess HealthCare - Chestnut Hill / Ob / Gyn Clinic200 Boylston StreetNewtonMAActive
DSH220086NChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBeth Israel Deaconess HealthCare - Chestnut Hill / Sports Medicine200 Boylston StreetNewtonMAActive
DSH220086PChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERThe Cancer Center at Beth Israel Deaconess Medical Center - Needham / Lab Services At Cancer Center - Needham148 Chestnut StNeedhamMATerminated
DSH220086QChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERThe Cancer Center at Beth Israel Deaconess Medical Center - Needham / Radiation Oncology 148 Chestnut StNeedhamMAActive
DSH220086RChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERThe Cancer Center at Beth Israel Deaconess Medical Center - Needham / Med/Surg Specialty 148 Chestnut StNeedhamMAActive
DSH220086SChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - RADIOLOGY SERVICES482 BEDFORD STREETLEXINGTONMAActive
DSH220086TChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - GI OFFICE482 BEDFORD STREETLEXINGTONMAActive
DSH220086UChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER NORTH - PODIATRY CLINIC1000 BROADWAY STREETCHELSEAMAActive
DSH220086VChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - VASCULAR SURGERY CLINIC110 FRANCIS STREETBOSTONMAActive
DSH220086WChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERLOWRY MEDICAL OFFICE - ENDOCRINOLOGY CLINIC110 FRANCIS STREETBOSTONMAActive
DSH220086XChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERMEDICAL CARE CENTER OF LEXINGTON - CARDIOLOGY CLINIC482 BEDFORD STREETLEXINGTONMAActive
DSH220086YChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBOWDOIN STREET HEALTH CENTER - OB/GYN CLINIC230 BOWDOIN STREETDORCHESTERMAActive
DSH220086ZChildDSHBETH ISRAEL DEACONESS MEDICAL CENTERBOWDOIN STREET HEALTH CENTER - OPTOMETRY CLINIC230 BOWDOIN STREETDORCHESTERMAActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsStateUpdate ApprovedActive4/1/2025 12:01 AM
ContactsSigned ByInsertNew Registration Larkin, Matthew Chief Operating Officer BIDMC 61767771441/27/2025 8:39 AM
Details340B IDUpdateNew Registration DSH220086DY1/27/2025 8:39 AM
DetailsEntity SubnameUpdateNew RegistrationBETH ISRAEL DEACONESS MEDICAL CENTEBETH ISRAEL DEACONESS MEDICAL CENTE - HEMONC INFUSION1/27/2025 8:39 AM
DatesParticipating Approval DateUpdateNew Registration 1/27/2025 8:39:20 AM1/27/2025 8:39 AM
DetailsStateUpdateNew RegistrationPendingApproved1/27/2025 8:39 AM
DatesSigned By DateUpdateNew Registration 1/13/2025 3:57:42 PM1/27/2025 8:39 AM
DatesStart DateUpdateNew Registration 4/1/2025 12:00:00 AM1/27/2025 8:39 AM
AddressesMain AddressInsertNew Registration  330 BROOKLINE AVE BOSTON, MA 02215-54001/13/2025 10:25 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False1/13/2025 10:25 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 110000014C1/13/2025 10:25 AM
Medicaid BillingMedicaid: StateInsertNew Registration MA1/13/2025 10:25 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False1/13/2025 10:25 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 110000014D1/13/2025 10:25 AM
Medicaid BillingMedicaid: StateInsertNew Registration MA1/13/2025 10:25 AM
Medicaid BillingNPI: NumberInsertNew Registration 15482026411/13/2025 10:25 AM
Medicaid BillingNPI: StateInsertNew Registration MA1/13/2025 10:25 AM
ContactsPrimary ContactInsertNew Registration Murphy, Laura Emilee 340B Program Manager Lahey 9789223000-36251/13/2025 10:25 AM
ContactsAuthorizing OfficialInsertNew Registration Larkin, Matthew Chief Operating Officer BIDMC 61767771441/13/2025 10:25 AM
DetailsAssistance Received From DateInsertNew Registration  1/13/2025 10:25 AM
DetailsAssistance Received To DateInsertNew Registration  1/13/2025 10:25 AM
DetailsLast Recertification DateInsertNew Registration  1/13/2025 10:25 AM
DetailsGrant NumberInsertNew Registration  1/13/2025 10:25 AM
Details340B IDInsertNew Registration  1/13/2025 10:25 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  1/13/2025 10:25 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  1/13/2025 10:25 AM
DetailsMedicare Provider NumberInsertNew Registration 2200861/13/2025 10:25 AM
DetailsEntity NameInsertNew Registration BETH ISRAEL DEACONESS MEDICAL CENTER1/13/2025 10:25 AM
DetailsNOFO NumberInsertNew Registration  1/13/2025 10:25 AM
DetailsProgram CodeInsertNew Registration DSH1/13/2025 10:25 AM
DetailsEntity SubnameInsertNew Registration BETH ISRAEL DEACONESS MEDICAL CENTE1/13/2025 10:25 AM
DatesParticipating Approval DateInsertNew Registration  1/13/2025 10:25 AM
DetailsStateInsertNew Registration Pending1/13/2025 10:25 AM
DatesRegistration DateInsertNew Registration 1/13/2025 10:25:54 AM1/13/2025 10:25 AM
DatesSigned By DateInsertNew Registration  1/13/2025 10:25 AM
DatesStart DateInsertNew Registration  1/13/2025 10:25 AM
TerminationsTermination CommentsInsertNew Registration  1/13/2025 10:25 AM
TerminationsTermination DateInsertNew Registration  1/13/2025 10:25 AM
TerminationsTermination Effective DateInsertNew Registration  1/13/2025 10:25 AM
TerminationsTermination ReasonInsertNew Registration  1/13/2025 10:25 AM