340B Drug Pricing Program Database


DSH410007 RHODE ISLAND HOSPITAL (Active) - information as of 4/28/2025 12:40:56 AM

Main Details
RHODE ISLAND HOSPITAL
Disproportionate Share Hospital
No
DSH410007
410007


Additional Details
Active
10/19/2007
4/1/2004
10/19/2007
8/19/2024

Contacts

Brown University Health
Michael D Dawson, VP Finance
(401) 444-2648

Brown University Health
CHRISTINE COLLINS, SVP, Pharmacy & Periop, Chief Pharmacy Officer
(401) 444-4434

Addresses

593 EDDY STREET
PROVIDENCE, RI 02903

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
MA110066635A,110066635B1588659528
RIOP000071588659528
Shipping Addresses

Safecor Health, LLC
317 New Boston Street, Suite 100
Woburn, MA 01801

PETNET Solutions Inc
268 West Cummings Park
Woburn, MA 01801

Rhode Island HSP EG LCI PHCY 340B
1454 South County Trail
East Greenwich, RI 02818

RIH Newport LCI Pharmacy
11 Friendship St.
Newport, RI 02840

RIH Lincoln LCI Pharmacy
701 George Washington Highway
Suite 101
Lincoln, RI 02865

RIH TMH Fain LCI Pharmacy
164 Summit Ave
Fain LCI
Providence, RI 02906
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750204/10/202007/01/2020  07/01/2020
Contract DetailACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201004/10/202007/01/2020  07/01/2020
Contract DetailACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884904/10/202007/01/2020  07/01/2020
Contract DetailACCREDO HEALTH GROUP INC261 CEDAR HILL ST BUILDING C
MARLBOROUGHMA01752-305607/15/202107/26/2021  07/26/2021
Contract DetailACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624104/10/202007/01/2020 07/31/202308/05/2024
Contract DetailACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282204/10/202007/01/2020  07/01/2020
Contract DetailACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349204/10/202007/01/2020  07/01/2020
Contract DetailAETNA SPECIALTY PHARMACY, LLC503 SUNPORT LN
ORLANDOFL32809-787404/14/202007/01/2020 04/01/202204/14/2022
Contract DetailBROWN UNIVERSITY HEALTH PHARMACY NO 001DAVOL BUILDING 593 EDDY STREET
PROVIDENCERI0290304/12/201307/01/2013  05/10/2017
Contract DetailBROWN UNIVERSITY HEALTH PHARMACY NO 002164 SUMMIT AVE
PROVIDENCERI0290610/07/201401/01/2015  05/10/2017
Contract DetailBROWN UNIVERSITY HEALTH PHARMACY NO 003180 CORLISS ST STE A
PROVIDENCERI0290404/12/201907/01/2019  07/01/2019
Contract DetailBROWN UNIVERSITY HEALTH PHARMACY NO 00511 FRIENDSHIP ST SHEFFIELD BLDG 1ST FL
NEWPORTRI0284004/07/202104/12/2021  04/12/2021
Contract DetailBROWN UNIVERSITY HEALTH SPECIALTY PHARMA117 CHAPMAN ST STE 200
PROVIDENCERI0290507/15/201910/01/2019  10/01/2019
Contract DetailCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361404/14/202007/01/2020  07/01/2020
Contract DetailCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005604/14/202007/01/2020  07/01/2020
Contract DetailCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621904/14/202007/01/2020  07/01/2020
Contract DetailCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175704/14/202007/01/2020  07/01/2020
Contract DetailCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808304/14/202007/01/2020  07/01/2020
Contract DetailCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700404/14/202007/01/2020  07/01/2020
Contract DetailCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761704/14/202007/01/2020  07/01/2020
Contract DetailCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813304/14/202007/01/2020  07/01/2020
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237404/14/202007/01/2020  07/01/2020
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911907/15/202107/26/2021  07/26/2021
Contract DetailCORAM ALTERNATE SITE SERVICES, INC.DBA CORAM CVS/SPECIALTY INFUSION SERVICE 6 SPRING MILL DR
MALVERNPA1935504/08/202507/01/2025  04/08/2025
Contract DetailCORAM ALTERNATE SITE SERVICES, INC.DBA CORAM CVS/SPECIALTY INFUSION SERVICE 2345 WATERS DRIVE
MENDOTA HEIGHTSMN5512004/08/202507/01/2025  04/08/2025
Contract DetailCORAM HEALTHCARE CORPORATION OF MASSACHUCORAM CVS/SPECIALTY INFUSION SERVICES 575 UNIVERSITY AVENUE
SUITE 2 		NORWOODMA0206204/14/202007/01/2020 01/09/202504/08/2025
Contract DetailCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/14/202011/24/2020  11/24/2020
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/14/202011/24/2020  11/24/2020
Contract DetailCVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502804/14/202007/01/2020  07/01/2020
Contract DetailCYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503301/13/202101/21/2021  01/21/2021
Contract DetailDIPLOMAT SPECIALTY PHARMACY4100 S SAGINAW ST STE D
FLINTMI48507-268310/14/202011/09/2020 04/15/202207/11/2022
Contract DetailOPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191304/07/202007/01/2020 01/13/202101/13/2021
Contract DetailOPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191307/17/202310/01/2023  10/01/2023
Contract DetailOPTUM FRONTIER THERAPIES, LLC325 W ATHERTON RD SUITE 1
FLINTMI48507-260107/17/202310/01/2023  10/01/2023
Contract DetailOPTUM INFUSION SERVICES 305, LLC15529 COLLEGE BLVD.
LENEXAKS66219-135104/14/202204/26/2022  04/26/2022
Contract DetailOPTUM INFUSION SERVICES 305, LLC4000 CHEMICAL RD STE 100
PLYMOUTH MEETINGPA1946204/14/202204/26/2022  04/26/2022
Contract DetailOPTUM PHARMACY 700, LLC19 CHAPIN RD BLDG D, STE D8
PINE BROOKNJ0705810/14/202011/09/2020  11/09/2020
Contract DetailOPTUM PHARMACY 701, LLC4100 S SAGINAW ST STE D
FLINTMI4850704/14/202204/15/2022  04/21/2022
Contract DetailOPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713004/07/202007/01/2020  07/01/2020
Contract DetailOPTUM PHARMACY 705, LLC1100 LEE BRANCH LN
BIRMINGHAMAL35242-729804/07/202007/01/2020  07/01/2020
Contract DetailOPTUM PHARMACY 706, INC.30-30 47TH AVENUE SUITE 410
LONG ISLAND CITYNY1110104/07/202007/01/2020  07/01/2020
Contract DetailOPTUM PHARMACY 707, INC4900 RIVERGRADE RD STE E110
IRWINDALECA91706-140107/11/202310/01/2023  10/01/2023
Contract DetailOPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508504/07/202007/01/2020  07/01/2020
Contract DetailOPTUMRXOPTUMRX INC 6800 W 115TH ST STE 600
OVERLAND PARKKS66211-983810/10/202401/01/2025  01/01/2025
Contract DetailPRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999201/13/202101/21/2021 10/01/202201/11/2023
Contract DetailPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514604/14/202007/01/2020  07/01/2020
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2293 2 DUDLEY STREET SUITE 170
PROVIDENCERI0290510/26/201210/26/2012 06/30/201706/30/2017
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2293 2 DUDLEY STREET SUITE 170
PROVIDENCERI0290504/14/202007/01/2020  07/01/2020
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523304/14/202007/01/2020  07/01/2020
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920304/14/202007/01/2020  07/01/2020
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY # 2516 35 KNEELAND STREET
BOSTONMA0211104/07/202104/12/2021  04/12/2021
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00642 767 WARWICK AVENUE
WARWICKRI0288810/26/201210/26/2012 06/30/201706/30/2017
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00212 681 RESERVOIR AVENUE
CRANSTONRI0291004/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00326 120 EDDIE DOWLING HWY.
NORTH SMITHFIELDRI0289604/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00621 763 TIOGUE AVENUE
COVENTRYRI0281604/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00670 601 SMITHFIELD AVENUE
PAWTUCKETRI0286004/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00994 131 WEBSTER AVENUE
PROVIDENCERI0290904/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02347 640 WARREN AVENUE
EAST PROVIDENCERI0291404/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04096 309 BROAD ST.
CENTRAL FALLSRI0286304/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04796 960 BROAD STREET
PROVIDENCERI0290504/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 5107 1285 S. COUNTY TRAIL
EAST GREENWICHRI0281804/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 01042 835 NEWPORT AVE.
PAWTUCKETRI0286104/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02065 11 MAIN ST.
WAKEFIELDRI0287904/14/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00351 1919 MINERAL SPRING AVENUE
NORTH PROVIDENCERI0290404/15/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00494 1400 HARTFORD AVENUE
JOHNSTONRI0291904/15/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02417 935 MANTON AVENUE
PROVIDENCERI0290904/15/202007/01/2020  07/01/2020
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00728 315 BROAD ST,
CUMBERLANDRI0286404/07/202104/12/2021  04/12/2021
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00247 444 WILLETT AVENUE
RIVERSIDERI0291504/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00265 615 METACOM AVENUE, ROUTE 136
WARRENRI0288504/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00330 445 PUTNAM PIKE
APPLE VALLEY MALL 		GREENVILLERI0282804/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00469 1188 PONTIAC AVENUE
CRANSTONRI0292004/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00493 99 EAST MAIN ROAD
MIDDLETOWNRI0284204/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00595 6495 POST ROAD
NORTH KINGSTOWNRI0285204/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00642 767 WARWICK AVENUE
WARWICKRI0288804/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00733 2400 WARWICK AVE
MEADOWBROOK PLAZA 		WARWICKRI0288904/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00856 400 ADMIRAL STREET
PROVIDENCERI0290804/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 01414 1195 OAKLAWN AVENUE
CRANSTONRI0292004/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 01544 151 FRANKLIN ST.
WESTERLYRI0289104/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02021 205 ATWOOD AVENUE
CRANSTONRI0292004/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02048 1068 PUTNAM PIKE, PO BOX H
GLOCESTERRI0281404/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02234 425 EAST AVENUE
PAWTUCKETRI0286004/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 2238 26 PUTNAM PIKE
JOHNSTONRI0291904/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02323 1734 MAIN STREET
WEST WARWICKRI0289304/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02358 10 TURNPIKE AVE
PORTSMOUTHRI0287104/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02384 834 PROVIDENCE STREET
WEST WARWICKRI0289304/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 5868 1776 BROAD ST.
CRANSTONRI0290504/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 08320 1187 MAIN ST., PO BOX 58
WYOMINGRI0289804/14/202204/26/2022  04/26/2022
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00037 1998 MENDON ROAD
CUMBERLANDRI0286404/08/202507/01/2025  04/08/2025
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 00729 799 HOPE STREET
PROVIDENCERI0290604/08/202507/01/2025  04/08/2025
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 01294 481 ANGELL STREET
PROVIDENCERI0290604/08/202507/01/2025  04/08/2025
Contract DetailRHODE ISLAND CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 02049 PROVIDENCE PLACE MALL, SUITE 1010
39 PROVIDENCE PLACE 		PROVIDENCERI0290304/08/202507/01/2025  04/08/2025
Contract DetailUMASS MEMORIAL MEDICAL CENTER, INC.UMASS MEMORIAL MEDICAL CENTER SPECIALTY 55 LAKE AVE N
ACC BUILDING - 1ST FLOOR - SUITE AC1.033 		WORCESTERMA01655-000204/12/201907/01/2019 01/03/202202/01/2022
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 04145 533 ELMWOOD AVE.
PROVIDENCERI0290701/13/202101/21/2021  01/21/2021
Contract DetailWALGREEN EASTERN CO., INC.WALGREENS #19849 655 WARREN AVE.
EAST PROVIDENCERI0291401/13/202101/21/2021  01/21/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 02850 1010 PARK AVE
CRANSTONRI0291010/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 03204 295 ACADEMY AVENUE
PROVIDENCERI0290810/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 03468 100 BROAD ST
PAWTUCKETRI0286010/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 03491 1763 BROAD ST
CRANSTONRI0290510/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 03737 1074 MINERAL SPRING AVE.
NORTH PROVIDENCERI02904-410410/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 06592 1560 WARWICK AVE
WARWICKRI02889-102010/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 06892 591 METACOM AVENUE
BRISTOLRI02809-513110/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS #10099 333 ATWELLS AVE STE 1
PROVIDENCERI0290310/13/202101/01/2022  01/01/2022
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS #10256 1140 N. MAIN ST.
PROVIDENCERI02904-181910/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS #11128 875 TIOGUE AVE.
COVENTRYRI02816-630010/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS #13987 385 COTTAGE ST.
PAWTUCKETRI02861-160310/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS #15538 335 PRAIRIE AVENUE
PROVIDENCERI0290510/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.WALGREENS #17519 220 NEWPORT AVE.
RUMFORDRI0291610/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.WALGREENS #18378 1086 WILLETT AVE.
RIVERSIDERI0291510/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.WALGREENS #19900 135 PITMAN ST.
PROVIDENCERI0290610/13/202112/27/2021  12/27/2021
Contract DetailWALGREEN EASTERN CO., INC.WALGREENS #19844 500 BROAD ST STE 6
PROVIDENCERI02907-136704/14/202204/26/2022 02/27/202404/12/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 03703 354 ADMIRAL STREET
PROVIDENCERI0290804/14/202204/26/2022  04/26/2022
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 03899 1387 PLAINFIELD ST
JOHNSTONRI0291904/14/202204/26/2022  04/26/2022
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS #11147 1 POCASSET AVE.
PROVIDENCERI02909-290704/14/202204/26/2022  04/26/2022
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS #10476 1583 ATWOOD AVE.
JOHNSTONRI0291904/14/202204/26/2022  04/26/2022
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS #21414 854 PURCHASE ST
NEW BEDFORDMA0274007/11/202310/01/2023  10/01/2023
Contract DetailWalgreens Central Fill #2140044 Cabot Blvd.
MansfieldMA0204801/11/202302/14/2023  02/14/2023
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCALLIANCERX WALGREENS PRIME #12314 9775 SW GEMINI DR, STE 1
BEAVERTONOR9700801/13/202101/21/2021 10/15/202110/15/2021
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818801/13/202101/21/2021  01/21/2021
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503301/13/202101/21/2021  01/21/2021
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527501/13/202101/21/2021  01/21/2021
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH410007AChildDSHRHODE ISLAND HOSPITALDialysis Center of RI Hospital117 Chapman StProvidenceRIActive
DSH410007AAChildDSHRHODE ISLAND HOSPITALNeuro Rehab Services765 Allens Avenue Suite 200ProvidenceRIActive
DSH410007ABChildDSHRHODE ISLAND HOSPITALRIH Rheumatology Infusion407 East Avenue Suite 200PawtucketRIActive
DSH410007ACChildDSHRHODE ISLAND HOSPITALRIH East Providence Infusion Services375 Wampanoag TrailEast ProvidenceRIActive
DSH410007ADChildDSHRHODE ISLAND HOSPITALLIFESPAN RECOVERY CENTER - TREATMENT CLINIC200 CORLISS STREETPROVIDENCERIActive
DSH410007AEChildDSHRHODE ISLAND HOSPITALAdolescent Center EP - Clinic900 Warren AvenueEast ProvidenceRIActive
DSH410007AFChildDSHRHODE ISLAND HOSPITALSleep Disorder Center EP - Pulmonary Function Testing70 Catamore BoulevardEast ProvidenceRIActive
DSH410007AGChildDSHRHODE ISLAND HOSPITALCardio / Pulm Center EG - Clinic1454 South County TrailEast GreenwichRIActive
DSH410007AHChildDSHRHODE ISLAND HOSPITALAdolescent Medicine EG - Primary Care Clinic1454 South County TrailEast GreenwichRIActive
DSH410007AJChildDSHRHODE ISLAND HOSPITALEast Greenwich Center - Clinic1454 South County TrailEast GreenwichRIActive
DSH410007AKChildDSHRHODE ISLAND HOSPITALPediatric Specialties EP - Clinic900 Warren AveEast ProvidenceRIActive
DSH410007ALChildDSHRHODE ISLAND HOSPITALPediatric GI Clinic EG - Clinic1454 South County TrailEast GreenwichRIActive
DSH410007AMChildDSHRHODE ISLAND HOSPITALPediatric GI Clinic EP - Clinic900 Warren AvenueEast ProvidenceRIActive
DSH410007ANChildDSHRHODE ISLAND HOSPITALOccupational Therapy - Occupational Therapy235 Plain StreetProvidenceRIActive
DSH410007APChildDSHRHODE ISLAND HOSPITALNorman Prince Spine Institute690 Eddy StreetProvidenceRIActive
DSH410007AQChildDSHRHODE ISLAND HOSPITALFamilies First/CEDARR - Pediatrics335R Prairie AveProvidenceRIActive
DSH410007ARChildDSHRHODE ISLAND HOSPITALPedi Palliative Care / Pain - Pediatrics765 Allens AvenueProvidenceRIActive
DSH410007ASChildDSHRHODE ISLAND HOSPITALAllergy Pulmonary Center - Clinic900 Warren AvenueEast ProvidenceRIActive
DSH410007ATChildDSHRHODE ISLAND HOSPITALPediatric Specialties EG - Clinic1454 South County TrailEast GreenwichRIActive
DSH410007AUChildDSHRHODE ISLAND HOSPITALRehab East Greenwich - Clinic1454 South County TrailEast GreenwichRIActive
DSH410007AVChildDSHRHODE ISLAND HOSPITALWound Care & Hyperbaric Center - Clinic950 Warren AvenueEast ProvidenceRIActive
DSH410007AWChildDSHRHODE ISLAND HOSPITALRIH LINCOLN INFUSION CENTER - ONCOLOGY701 George Washington HwyLINCOLNRIActive
DSH410007AXChildDSHRHODE ISLAND HOSPITALALLERGY/PULMONARY CTR - PULMONARY1454 SOUTH COUNTY TRAILEAST GREENWICHRIActive
DSH410007AYChildDSHRHODE ISLAND HOSPITALPediatric Sleep Lab1407 South County TrailEast GreenwichRIActive
DSH410007AZChildDSHRHODE ISLAND HOSPITALEEG Neuro Laboratory1407 South County TrailEast GreenwichRITerminated
DSH410007BChildDSHRHODE ISLAND HOSPITALPediatric Physical Therapy765 Allens AvenueProvidenceRITerminated
DSH410007BAChildDSHRHODE ISLAND HOSPITALHCH Complex Care Clinic - Clinic2 Dudley StProvidenceRIActive
DSH410007BBChildDSHRHODE ISLAND HOSPITALGENETIC CLINIC - GENETIC CLINIC111 Plain ST FL2ProvidenceRIActive
DSH410007BCChildDSHRHODE ISLAND HOSPITALRIH WEST RIVER INFUSION CTR - RIH WEST RIVER INFUSION CTR148 West River Street STE 2BProvidenceRIToBeTerminated
DSH410007BDChildDSHRHODE ISLAND HOSPITALRIH CPC Psychiatry - Psychiatry245 Chapman StreetProvidenceRIApproved
DSH410007BEChildDSHRHODE ISLAND HOSPITALRIH Adult GI - Specialty Clinic245 Chapman StreetProvidenceRIApproved
DSH410007BFChildDSHRHODE ISLAND HOSPITALRIH CVI West River - Center for Advanced Lung Care146 West River StreetProvidenceRIApproved
DSH410007BGChildDSHRHODE ISLAND HOSPITALRIH Adult IBD - Specialty Clinic245 Chapman StreetProvidenceRIApproved
DSH410007BHChildDSHRHODE ISLAND HOSPITALRIH Calc Pulmonary - Center for Advanced Lung Care146 West River StreetProvidenceRIApproved
DSH410007CChildDSHRHODE ISLAND HOSPITALAudiology / Speech Pathology115 Georgia AvenueProvidenceRIActive
DSH410007DChildDSHRHODE ISLAND HOSPITALHallett Center900 Warren AvenueEast ProvidenceRITerminated
DSH410007EChildDSHRHODE ISLAND HOSPITALAdolescent Health1 Hoppin StreetProvidenceRIActive
DSH410007FChildDSHRHODE ISLAND HOSPITALDiabetes and Endocrinolgy111 Plain St.ProvidenceRIActive
DSH410007GChildDSHRHODE ISLAND HOSPITALOccupational Therapy765 Allens AvenueProvidenceRIActive
DSH410007HChildDSHRHODE ISLAND HOSPITALPhysical Therapy ( Adult )765 Allens AvenueProvidenceRIActive
DSH410007JChildDSHRHODE ISLAND HOSPITALElectrocardiology Lab ( Stress Lab ) 1 Hoppin StreetProvidenceRITerminated
DSH410007KChildDSHRHODE ISLAND HOSPITALEye Clinic1 Hoppin StreetProvidenceRITerminated
DSH410007LChildDSHRHODE ISLAND HOSPITALMED/PEDS Program245 Chapman StreetProvidenceRIActive
DSH410007MChildDSHRHODE ISLAND HOSPITALCenter for Special Children335 R Prairie AveProvidenceRIActive
DSH410007NChildDSHRHODE ISLAND HOSPITALMedical Primary Care Clinic245 Chapman StreetProvidenceRIActive
DSH410007PChildDSHRHODE ISLAND HOSPITALEP Outpatient Dialysis950 Warren AvenueEast ProvidenceRIActive
DSH410007QChildDSHRHODE ISLAND HOSPITALCancer Center at NH11 Friendship StreetNewportRIActive
DSH410007RChildDSHRHODE ISLAND HOSPITALEast Greenwich Cancer Center1454 S. County TrailEast GreenwichRIActive
DSH410007SChildDSHRHODE ISLAND HOSPITALCancer Center at TMH164 Summit StreetPROVIDENCERIActive
DSH410007TChildDSHRHODE ISLAND HOSPITALMedical Specialty Clinic245 Chapman StreetPROVIDENCERIActive
DSH410007UChildDSHRHODE ISLAND HOSPITALChild Protection Clinic (Hasbro)1 Hoppin St., Rm 3055ProvidenceRITerminated
DSH410007VChildDSHRHODE ISLAND HOSPITALPediatric Cardiolgy Center (Hasbro)1 Hoppin St., Rm 304AProvidenceRIActive
DSH410007WChildDSHRHODE ISLAND HOSPITALCardio-Pulmonary Lab. (Hasbro)1 Hoppin St., Rm. 304ProvidenceRIActive
DSH410007XChildDSHRHODE ISLAND HOSPITALChildren's Rehab. Services765 Allen Ave., Suite 200ProvidenceRIActive
DSH410007ZChildDSHRHODE ISLAND HOSPITALWayland Square Surgical Center17 Seekonk StProvidenceRITerminated
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
ContactsAuthorizing OfficialUpdateAO Change RequestGreenwood, Eva Senior VP Finance Lifespan 4014442221Dawson, Michael D VP Finance Brown University Health 401444264812/4/2024 7:36 AM
ContactsPrimary ContactUpdateProfile Change RequestCOLLINS, CHRISTINE Vice President and Chief Pharmacy Officer Lifespan 4014444434COLLINS, CHRISTINE SVP, Pharmacy & Periop, Chief Pharmacy Officer Brown University Health 401444443411/15/2024 11:13 AM
AddressesShipping AddressUpdateChange RequestRIH TMH Fain LCI Pharmacy 164 Summit Ave Providence, RI 02906RIH TMH Fain LCI Pharmacy 164 Summit Ave Fain LCI Providence, RI 029069/3/2024 2:58 PM
DetailsLast Recertification DateUpdateRecertification8/15/2023 5:14:43 PM8/19/2024 2:07:53 PM8/19/2024 2:07 PM
AddressesShipping AddressDeleteChange RequestRhode Island Convention Center (COVID) 1 Sabin Street 3rd Floor Pharmacy Providence, RI 02903 8/5/2024 2:11 PM
DetailsLast Recertification DateUpdateRecertification9/7/2022 9:46:41 AM8/15/2023 5:14:43 PM8/15/2023 5:14 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/10/2023 2:13 PM
Medicaid BillingMedicaid: NumberInsertChange Request 110066635A3/10/2023 2:13 PM
Medicaid BillingMedicaid: StateInsertChange Request MA3/10/2023 2:13 PM
Medicaid BillingMedicaid: Is PrimaryInsertChange Request False3/10/2023 2:13 PM
Medicaid BillingMedicaid: NumberInsertChange Request 110066635B3/10/2023 2:13 PM
Medicaid BillingMedicaid: StateInsertChange Request MA3/10/2023 2:13 PM
Medicaid BillingNPI: NumberInsertChange Request 15886595283/10/2023 2:13 PM
Medicaid BillingNPI: StateInsertChange Request MA3/10/2023 2:13 PM
ContactsAuthorizing OfficialUpdateAO Change RequestKirshner, David Executive Vice President and Chief Financial Officer Lifespan 4014447093Greenwood, Eva Senior VP Finance Lifespan 40144422211/11/2023 6:45 AM
DetailsLast Recertification DateUpdateRecertification8/27/2021 8:11:32 AM9/7/2022 9:46:41 AM9/7/2022 9:46 AM
AddressesShipping AddressInsertChange Request RIH Newport LCI Pharmacy 11 Friendship St. Newport, RI 028404/14/2022 12:30 PM
AddressesShipping AddressInsertChange Request RIH Lincoln LCI Pharmacy 701 George Washington Highway Suite 101 Lincoln, RI 028654/14/2022 12:30 PM
AddressesShipping AddressInsertChange Request RIH TMH Fain LCI Pharmacy 164 Summit Ave Providence, RI 029064/14/2022 12:30 PM
ContactsAuthorizing OfficialUpdateChange RequestWakefield, Mary Senior VP and CFO Rhode Island Hospital 4014447093Kirshner, David Executive Vice President and Chief Financial Officer Lifespan 401444709310/4/2021 11:22 AM
DetailsLast Recertification DateUpdateRecertification8/26/2020 12:24:12 PM8/27/2021 8:11:32 AM8/27/2021 8:11 AM
AddressesShipping AddressInsertChange Request Rhode Island HSP EG LCI PHCY 340B 1454 South County Trail East Greenwich, RI 028187/23/2021 1:42 PM
Medicaid BillingNPI: NumberInsertRecertification 15886595288/26/2020 12:24 PM
Medicaid BillingNPI: StateInsertRecertification RI8/26/2020 12:24 PM
Medicaid BillingNPI: NumberDeleteRecertification1588659528 ( ) 8/26/2020 12:24 PM
DetailsLast Recertification DateUpdateRecertification8/19/2019 10:29:37 AM8/26/2020 12:24:12 PM8/26/2020 12:24 PM
AddressesShipping AddressInsertChange Request Rhode Island Convention Center (COVID) 1 Sabin Street 3rd Floor Pharmacy Providence, RI 029034/15/2020 11:09 AM
ContactsPrimary ContactUpdateProfile Change RequestCOLLINS, CHRISTINE DIRECTOR OF PHARMACY Lifespan 4014444434COLLINS, CHRISTINE Vice President and Chief Pharmacy Officer Lifespan 401444443410/3/2019 7:17 AM
DetailsLast Recertification DateUpdateRecertification9/3/2018 9:34:42 AM8/19/2019 10:29:37 AM8/19/2019 10:29 AM
AddressesShipping AddressInsertChange Request PETNET Solutions Inc 268 West Cummings Park Woburn, MA 018018/13/2019 6:40 AM
Medicaid BillingMedicaid: NumberUpdateRecertificationOP0007OP000079/3/2018 9:34 AM
DetailsLast Recertification DateUpdateRecertification11/15/2017 2:18:05 PM9/3/2018 9:34:42 AM9/3/2018 9:34 AM
DetailsLast Recertification DateUpdateRecertification8/22/2016 12:00:00 AM11/15/2017 2:18:05 PM11/15/2017 2:18 PM
ContactsPrimary ContactUpdate COLLINS, CHRISTINE DIRECTOR OF PHARMACY 4014444434COLLINS, CHRISTINE DIRECTOR OF PHARMACY Lifespan 401444443410/6/2017 12:11 PM
ContactsAuthorizing OfficialUpdate Wakefield, Mary Senior VP and CFO 4014447093Wakefield, Mary Senior VP and CFO Rhode Island Hospital 401444709310/4/2017 2:25 PM
ContactsAuthorizing OfficialInsert  Wakefield, Mary Senior VP and CFO 40144470936/30/2017 6:27 PM
ContactsPrimary ContactUpdate COLLINS, CHRISTINE DIRECTOR OF PHARMACY 4014444434COLLINS, CHRISTINE DIRECTOR OF PHARMACY 40144444345/10/2017 5:14 PM
AddressesMain AddressInsert   593 EDDY STREET PROVIDENCE, RI 029035/10/2017 5:14 PM
AddressesShipping AddressInsert  Safecor Health, LLC 317 New Boston Street, Suite 100 Woburn, MA 018015/10/2017 5:14 PM
DetailsLast Recertification DateUpdate 8/28/2015 12:00:00 AM8/22/2016 12:00:00 AM8/22/2016 1:40 PM
Medicaid BillingMedicaid: Is PrimaryUpdate TrueFalse8/28/2015 4:59 PM
DetailsLast Recertification DateUpdate 8/7/2014 12:00:00 AM8/28/2015 12:00:00 AM8/28/2015 4:59 PM
DetailsLast Recertification DateUpdate 9/6/2013 12:00:00 AM8/7/2014 12:00:00 AM8/7/2014 2:34 PM
DetailsLast Recertification DateUpdate 7/1/2012 12:00:00 AM9/6/2013 12:00:00 AM9/6/2013 5:35 PM
Medicaid BillingNPI: NumberInsert  15886595285/18/2012 12:28 PM
DetailsLast Recertification DateUpdate  7/1/2012 12:00:00 AM5/18/2012 12:28 PM
ContactsPrimary ContactUpdate COLLINS, CHRISTINE DIRECTOR OF PHARMACY 4014444434COLLINS, CHRISTINE DIRECTOR OF PHARMACY 40144444343/2/2012 9:31 AM
ContactsPrimary ContactInsert  COLLINS, CHRISTINE DIRECTOR OF PHARMACY 40144444343/2/2012 9:30 AM
DatesParticipating Approval DateUpdate 10/19/2007 2:17:21 PM10/19/2007 12:00:00 AM3/2/2012 9:30 AM
DetailsLast Recertification DateInsert   10/19/2007 2:20 PM
DetailsGrant NumberInsert   10/19/2007 2:20 PM
Details340B IDInsert  DSH41000710/19/2007 2:20 PM
DetailsIs Authorizing Official EHB DataInsert   10/19/2007 2:20 PM
DatesLast Date That 340B Drugs PurchasedInsert   10/19/2007 2:20 PM
DetailsMedicare Provider NumberInsert  41000710/19/2007 2:20 PM
DetailsEntity NameInsert  RHODE ISLAND HOSPITAL10/19/2007 2:20 PM
DetailsProgram CodeInsert  DSH10/19/2007 2:20 PM
DetailsEntity SubnameInsert   10/19/2007 2:20 PM
DatesParticipating Approval DateInsert  10/19/2007 2:17:21 PM10/19/2007 2:20 PM
DetailsStateInsert  Active10/19/2007 2:20 PM
DatesRegistration DateInsert  10/19/2007 12:00:00 AM10/19/2007 2:20 PM
DatesSigned By DateInsert  8/13/2007 12:00:00 AM10/19/2007 2:20 PM
DatesStart DateInsert  4/1/2004 12:00:00 AM10/19/2007 2:20 PM
TerminationsTermination CommentsInsert   10/19/2007 2:20 PM
TerminationsTermination DateInsert   10/19/2007 2:20 PM
TerminationsTermination Effective DateInsert   10/19/2007 2:20 PM
TerminationsTermination ReasonInsert   10/19/2007 2:20 PM
Medicaid BillingMedicaid: Is PrimaryInsert  True10/19/2007 2:19 PM
Medicaid BillingMedicaid: NumberInsert  OP000710/19/2007 2:19 PM
Medicaid BillingMedicaid: StateInsert  RI10/19/2007 2:19 PM