Covered Entity Details

DSH220116 TUFTS MEDICAL CENTER (Active) - information as of 4/30/2025 10:50:06 PM

Main Details

Name

TUFTS MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

Rural

340B ID

DSH220116

Medicare Provider Number

220116

Additional Details

Current Program Status

Active

Registration Date

5/2/2008

Participating Start Date

10/1/2003

Participating Approval Date

5/2/2008

Last Recertification Date

8/13/2024

Contacts

Authorizing Official

Tufts Medical Center
kevin michael bennett, SVP, Finance
(617) 636-2533

Primary Contact

Tufts Medical Center
Joan Marie Calamari, Director of Pharmacy
(617) 877-0552

Addresses

Street Address

800 WASHINGTON STREET
BOSTON, MA 02111

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
5/2/08 ENT NAME CHANGE (WAS NEW ENGLAND MEDICAL CENTER), ADDR CHANGE (WAS 750-755 WASHINGTON STREET) 12/23/11 change Ao and PC from Burke and GOUVEIA to Agba and Thompson JH	12/23/2011
5/2/08 ENT NAME CHANGE (WAS NEW ENGLAND MEDICAL CENTER), ADDR CHANGE (WAS 750-755 WASHINGTON STREET)	05/02/2008

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
RI	OP20116,0220116	1730132515,1053350306,1851337141,1508948613
CT	003079789,003032570	1730132515,1053350306,1851337141,1508948613
VT	0220116	1730132515,1053350306,1851337141,1508948613
NH	3071222	1730132515,1053350306,1851337141,1508948613
MA	110020611G,110020611D	1730132515,1053350306,1851337141,1508948613
NY	01608240	1730132515,1053350306,1851337141,1508948613
ME		1730132515,1851337141,1053350306,1508948613

Shipping Addresses

Shipping Address 1

Tufts Medical Center - Blood Bank
800 Washington Street
Proger 8th Floor
Boston, MA 02111

Shipping Address 2

Tufts Medical Center
800 Washington Street
Boston, MA 02111

Shipping Address 3

Tufts Medical Center - Loading Dock
25 Harvard Street
Boston, MA 02111

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ACCREDO HEALTH GROUP INC	1620 CENTURY CENTER PKWY	# 109	MEMPHIS	TN	38134-8849	10/16/2017	01/01/2018		10/16/2017
Contract Detail	ACCREDO HEALTH GROUP INC	3000 ERICSSON DRIVE, SUITE 100		WARRENDALE	PA	15086-7502	10/16/2017	01/01/2018		10/16/2017
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	10/16/2017	01/01/2018	10/16/2017	10/16/2017
Contract Detail	ACCREDO HEALTH GROUP INC	261 CEDAR HILL ST	BUILDING C	MARLBOROUGH	MA	01752-3056	10/16/2017	01/01/2018		10/16/2017
Contract Detail	ACCREDO HEALTH GROUP INC	2040 W RIO SALADO PKWY STE 101B		TEMPE	AZ	85281-2010	10/12/2020	10/23/2020		10/23/2020
Contract Detail	ACCREDO HEALTH GROUP, INC.	6272 LEE VISTA BLVD STE 100		ORLANDO	FL	32822	10/16/2017	01/01/2018		10/16/2017
Contract Detail	ACCREDO HEALTH GROUP, INC.	2 BOULDEN CIR STE 1		NEW CASTLE	DE	19720-3492	10/16/2017	01/01/2018		10/16/2017
Contract Detail	ACCREDO HEALTH GROUP, INC.	2825 W PERIMETER RD STE 112		INDIANAPOLIS	IN	46241	10/16/2017	01/01/2018		10/16/2017
Contract Detail	ACCREDO HEALTH GROUP, INC.	4750 E 450 S	SUITE A	WHITESTOWN	IN	46075	04/14/2023	07/01/2023		07/01/2023
Contract Detail	AETNA SPECIALTY PHARMACY, LLC	503 SUNPORT LN		ORLANDO	FL	32809-7874	07/11/2019	10/01/2019	04/22/2024	04/29/2024
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	376 NORTHLAKE BLVD		ALTAMONTE SPRINGS	FL	32701-5261	07/18/2024	10/01/2024		10/01/2024
Contract Detail	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	BIOPLUS SPECIALTY PHARMACY SERVICES, LLC	4740 VICTORY LN STE C	INDIANAPOLIS	IN	46203	07/18/2024	10/01/2024		10/01/2024
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	10/09/2020	10/23/2020		10/23/2020
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	07/18/2017	10/01/2017		10/01/2017
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	10/12/2020	10/23/2020		10/23/2020
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	07/14/2015	10/01/2015		07/14/2015
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	10/12/2020	10/23/2020		10/23/2020
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	10/12/2020	10/23/2020		10/23/2020
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	10/09/2020	10/23/2020		10/23/2020
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	10/12/2020	10/23/2020		10/23/2020
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	10/12/2020	10/23/2020		10/23/2020
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	10/09/2020	10/23/2020		10/23/2020
Contract Detail	CORAM ALTERNATE SITE SERVICES, INC.	DBA CORAM CVS/SPECIALTY INFUSION SERVICE	6 SPRING MILL DR	MALVERN	PA	19355	01/13/2021	02/10/2021		02/10/2021
Contract Detail	CORAM HEALTHCARE CORPORATION OF MASSACHU	CORAM CVS/SPECIALTY INFUSION SERVICES	575 UNIVERSITY AVENUE SUITE 2	NORWOOD	MA	02062	01/13/2021	02/10/2021	02/03/2025	03/11/2025
Contract Detail	CVS CAREMARK	DBA CVS/CAREMARK OR CF# 11506	1 GREAT VALLEY BOULEVARD	WILKES BARRE	PA	18706	07/14/2021	10/01/2021		10/01/2021
Contract Detail	CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC	DBA CVS/CAREMARK 48067	1780 WALL ST	MT PROSPECT	IL	60056	07/14/2021	10/01/2021		10/01/2021
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 03307	400 TREMONT STREET	BOSTON	MA	02116	10/04/2012	10/04/2012	07/25/2023	07/25/2023
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01015	42 BEALE STREET	WOLLASTON	MA	02170	10/04/2012	10/04/2012		03/28/2013
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01217	587 BOYLSTON STREET	BOSTON	MA	02116	10/04/2012	10/04/2012		03/28/2013
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 02283	715 MORRISSEY BOULEVARD	DORCHESTER	MA	02122	10/04/2012	10/04/2012		03/28/2013
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00361	55 SUMMER STREET	BOSTON	MA	02110	10/04/2012	10/04/2012	02/07/2024	02/14/2024
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 05874	631 WASHINGTON ST.	BOSTON	MA	02111	10/04/2012	10/04/2012		03/28/2013
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00979	423 WEST BROADWAY	SOUTH BOSTON	MA	02127	02/21/2013	04/01/2013		03/28/2013
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00026	590 FELLSWAY	MEDFORD	MA	02155	04/26/2018	07/01/2018	10/01/2018	10/19/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00746	171 NORTH MAIN STREET	RANDOLPH	MA	02368	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 08972	285 COLUMBUS AVE.	BOSTON	MA	02116	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00159	516-522 MAIN STREET	MELROSE	MA	02176	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01259	231 MASSACHUSETTS AVENUE	BOSTON	MA	02115	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00672	32 FERRY STREET	MALDEN	MA	02148	04/26/2018	07/01/2018	10/01/2018	10/19/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00049	333 WASHINGTON STREET	BOSTON	MA	02108	04/26/2018	07/01/2018	10/01/2018	10/19/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01871	1280 WORCESTER RD.	FRAMINGHAM	MA	01702	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 02592	468 BLUE HILL AVE	DORCHESTER	MA	02121	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01009	21 AUSTIN STREET BUNKER HILL MALL	CHARLESTOWN	MA	02129	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01889	427 WASHINGTON STREET	BRIGHTON	MA	02135	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00026	590 FELLSWAY	MEDFORD	MA	02155	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00137	626 SOUTHERN ARTERY, RTE 3A	QUINCY	MA	02169	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00049	333 WASHINGTON STREET	BOSTON	MA	02108	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00672	32 FERRY STREET	MALDEN	MA	02148	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01264	704 CENTRE STREET	JAMAICA PLAIN	MA	02130	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 02282	703 GALLIVAN BOULEVARD	DORCHESTER	MA	02124	04/26/2018	07/01/2018		04/26/2018
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01252	874 HARRISON AVE	BOSTON	MA	02118	07/17/2018	10/01/2018	04/01/2022	02/14/2024
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01265	210 BORDER STREET	EAST BOSTON	MA	02128	07/11/2019	10/01/2019		10/01/2019
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01056	25 WOOD STREET	LOWELL	MA	01851	07/11/2019	10/01/2019		10/01/2019
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 02125	137 WEST CENTRAL STREET	NATICK	MA	01760	07/11/2019	10/01/2019		10/01/2019
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 02454	321 QUINCY SHORE DRIVE	QUINCY	MA	02171	07/11/2019	10/01/2019		10/01/2019
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01199	647 VFW PKWY,	CHESTNUT HILL	MA	02467	01/13/2021	02/10/2021		02/10/2021
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01900	218 HANOVER STREET	BOSTON	MA	02113	01/13/2021	02/10/2021		02/10/2021
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 07530	1249 BOYLSTON ST.	BOSTON	MA	02215	01/13/2021	02/10/2021	06/15/2022	02/14/2024
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00720	2235 DORCHESTER AVENUE	BOSTON	MA	02124	01/13/2021	02/10/2021		02/10/2021
Contract Detail	CVS PHARMACY, INC.	DBA CVS/PHARMACY #10174	700 ATLANTIC AVENUE	BOSTON	MA	02111	01/17/2023	02/08/2023		02/08/2023
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01263	10 BASSETT STREET	MILTON	MA	02186	01/17/2023	02/08/2023		02/08/2023
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 01001	1080 EASTERN AVE	MALDEN	MA	02148	01/17/2023	02/08/2023		02/08/2023
Contract Detail	CVS PHARMACY, INC.	DBA: CVS/PHARMACY # 00043	474 WASHINGTON ST.	WEYMOUTH	MA	02188	01/17/2023	02/08/2023		02/08/2023
Contract Detail	CVS PHARMACY, INC.	DBA CVS/PHARMACY #11082	341 HARRISON AVENUE	BOSTON	MA	02118	07/18/2023	10/01/2023		10/01/2023
Contract Detail	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	10/12/2020	10/23/2020		10/23/2020
Contract Detail	DIPLOMAT SPECIALTY PHARMACY	4100 S SAGINAW ST	STE D	FLINT	MI	48507-2683	04/15/2013	07/01/2013	07/09/2015	07/09/2015
Contract Detail	DIPLOMAT SPECIALTY PHARMACY	7 CREEK PKWY STE 700		UPPER CHICHESTER	PA	19061-3100	07/17/2018	10/01/2018	01/01/2021	01/13/2021
Contract Detail	DIPLOMAT SPECIALTY PHARMACY	4100 S SAGINAW ST	STE D	FLINT	MI	48507-2683	07/17/2018	10/01/2018	01/13/2023	01/17/2023
Contract Detail	GENOA HEALTHCARE LLC	173 OXFORD ST	LOWER LEVEL - SUITE P	LYNN	MA	01901	04/21/2021	07/01/2021	01/01/2022	01/12/2022
Contract Detail	GENOA HEALTHCARE LLC	176 WEST ST STE P		MILFORD	MA	01757	04/21/2021	07/01/2021	01/01/2022	01/12/2022
Contract Detail	GENOA HEALTHCARE LLC	301 BROADWAY STE P		CHELSEA	MA	02150	01/12/2022	04/01/2022	06/01/2022	06/15/2022
Contract Detail	GENOA HEALTHCARE LLC	330 RUTHERFORD AVE STE 1		CHARLESTOWN	MA	02129	01/12/2022	04/01/2022	06/01/2022	06/15/2022
Contract Detail	MAXI DRUG, INC.	RITE AID #10152	710 EAST BROADWAY	SOUTH BOSTON	MA	02127	12/03/2012	01/01/2013	02/21/2018	02/22/2018
Contract Detail	MAXI DRUG, INC.	RITE AID #10150	1100 DORCHESTER AVENUE	DORCHESTER	MA	02125	12/03/2012	01/01/2013	02/21/2018	02/22/2018
Contract Detail	MAXI DRUG, INC.	RITE AID #10151	90 RIVER STREET	MATTAPAN	MA	02126	12/03/2012	01/01/2013	02/21/2018	02/22/2018
Contract Detail	MAXI DRUG, INC.	RITE AID #10170	132 GRANITE STREET	QUINCY	MA	02169	12/03/2012	01/01/2013	02/21/2018	02/22/2018
Contract Detail	MAXI DRUG, INC.	RITE AID #10157	1329 HYDE PARK AVENUE	HYDE PARK	MA	02136	12/03/2012	01/01/2013	02/21/2018	02/22/2018
Contract Detail	MAXI DRUG, INC.	RITE AID #10168	467 SALEM STREET	MEDFORD	MA	02155	12/03/2012	01/01/2013	02/21/2018	02/22/2018
Contract Detail	MAXI DRUG, INC.	RITE AID #10164	405 BROADWAY	EVERETT	MA	02149	12/03/2012	01/01/2013	02/21/2018	02/22/2018
Contract Detail	MAXI DRUG, INC.	RITE AID #10170	132 GRANITE STREET	QUINCY	MA	02169	07/17/2018	10/01/2018	10/01/2018	10/19/2018
Contract Detail	MAXI DRUG, INC.	RITE AID #10150	1100 DORCHESTER AVENUE	DORCHESTER	MA	02125	07/17/2018	10/01/2018	10/01/2018	10/19/2018
Contract Detail	OPTION CARE ENTERPRISES, INC.	D/B/A OPTION CARE	734 FOREST ST. SUITE 300	MARLBOROUGH	MA	01752-3032	07/14/2021	10/01/2021		10/01/2021
Contract Detail	OPTION CARE ENTERPRISES, INC.	D/B/A OPTION CARE	11403 BLUEGRASS PARKWAY SUITE 400	LOUISVILLE	KY	40299-2398	07/14/2021	10/01/2021		10/01/2021
Contract Detail	OPTION CARE ENTERPRISES, INC.	OPTION CARE	870 N. ARLINGTON HEIGHTS RD SUITE 101	ITASCA	IL	60143	07/14/2021	10/01/2021		10/01/2021
Contract Detail	OPTUM FRONTIER THERAPIES II, LLC	6425 SANTA MARGARITA ST UNIT 110		LAS VEGAS	NV	89118-1913	01/14/2020	04/01/2020	08/31/2020	08/31/2020
Contract Detail	OPTUM PHARMACY 700, LLC	19 CHAPIN RD BLDG D, STE D8		PINE BROOK	NJ	07058	10/12/2020	10/23/2020	12/01/2023	01/15/2024
Contract Detail	OPTUM PHARMACY 701, LLC	4100 S SAGINAW ST STE D		FLINT	MI	48507	01/12/2022	01/13/2022	12/01/2023	01/15/2024
Contract Detail	OPTUM PHARMACY 701, LLC	1830 S HORNE		MESA	AZ	85204	10/16/2023	01/01/2024		01/01/2024
Contract Detail	OPTUM PHARMACY 702, LLC	1050 PATROL RD		JEFFERSONVILLE	IN	47130	01/14/2020	04/01/2020		04/01/2020
Contract Detail	OPTUM PHARMACY 704, INC.	5627 UNIVERSITY HTS STE 108		SAN ANTONIO	TX	78249	01/12/2022	04/01/2022	06/01/2022	06/15/2022
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	01/14/2020	04/01/2020	01/01/2021	01/13/2021
Contract Detail	OPTUM PHARMACY 705, LLC	11142 RENNER BLVD		LENEXA	KS	66219	10/12/2020	10/23/2020	05/21/2021	06/08/2021
Contract Detail	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	01/12/2022	04/01/2022	06/01/2022	06/15/2022
Contract Detail	OPTUM PHARMACY 705, LLC	1100 LEE BRANCH LN		BIRMINGHAM	AL	35242-7298	01/17/2023	02/08/2023		02/08/2023
Contract Detail	OPTUM PHARMACY 705, LLC	1893 GENERAL GEORGE PATTON DR	STE 106	FRANKLIN	TN	37067-2655	01/17/2023	02/08/2023		02/08/2023
Contract Detail	OPTUM PHARMACY 705, LLC	3539 BLUECUTT RD		COLUMBUS	MS	39705	01/17/2023	02/08/2023		02/08/2023
Contract Detail	OPTUM PHARMACY 706, INC.	30-30 47TH AVENUE	SUITE 410	LONG ISLAND CITY	NY	11101	01/14/2020	04/01/2020		04/01/2020
Contract Detail	OPTUM PHARMACY 707, INC	4900 RIVERGRADE RD STE E110		IRWINDALE	CA	91706-1401	10/09/2020	10/23/2020		10/23/2020
Contract Detail	OPTUM PHARMACY 801, INC.	24416 N 19TH AVE	STE. 100	PHOENIX	AZ	85085	01/15/2020	04/01/2020	01/01/2022	01/12/2022
Contract Detail	OPTUMRX	OPTUMRX INC	6800 W 115TH ST STE 600	OVERLAND PARK	KS	66211-9838	01/13/2021	02/10/2021		02/10/2021
Contract Detail	OPTUMRX	2858 LOKER AVE E STE 100		CARLSBAD	CA	92010-6608	01/13/2021	02/10/2021	05/27/2022	06/15/2022
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	04/09/2014	07/01/2014		04/09/2014
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	10/12/2020	10/23/2020		10/23/2020
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	10/12/2020	10/23/2020		10/23/2020
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 2516	35 KNEELAND STREET	BOSTON	MA	02111	07/14/2021	10/01/2021		10/01/2021
Contract Detail	RAINA RX LLC	DBA ROUTE 300 PHARMACY	1208 ROUTE 300 SUITE 103	NEWBURGH	NY	12550	07/18/2024	10/01/2024		10/01/2024
Contract Detail	TUFTS MEDICINE HOME INFUSION SERVICES	170 GOVERNORS AVE		MEDFORD	MA	02155	07/18/2022	10/01/2022		10/01/2022
Contract Detail	TUFTS MEDICINE PHARMACY, LLC	800 WASHINGTON ST		BOSTON	MA	02111	01/11/2022	04/01/2022		04/01/2022
Contract Detail	WALGREEN EASTERN CO INC	WALGREENS SPECIALTY PHARMACY #15307	21 STANHOPE STREET #23	BOSTON	MA	02116	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO. INC.	DBA STRAND, A WALGREENS PHARMACY #13806	533 COLUMBIA ROAD	DORCHESTER	MA	02125	11/27/2012	11/27/2012	03/09/2020	05/06/2020
Contract Detail	WALGREEN EASTERN CO. INC.	DBA WALGREENS #13805	397 BOSTON POST ROAD	WESTON	MA	02493	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO. INC.	DBA: WALGREENS #13804	266 WASHINGTON STREET	WELLESLEY	MA	02481-4922	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05755	413 WASHINGTON STREET	STOUGHTON	MA	02072-4210	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 01847	757 GALLIVAN BLVD STE 3	DORCHESTER	MA	02122	11/27/2012	11/27/2012	04/28/2025	04/28/2025
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 10317	1035 TRUMAN HWY	BOSTON	MA	02136	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #15001	980 AMERICAN LEGION HWY	ROSLINDALE	MA	02131-4701	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 01851	148 WEST CENTRAL	NATICK	MA	01760	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 01852	1478 HIGHLAND AVE	NEEDHAM	MA	02492	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 15969	505 PARADISE ROAD	SWAMPSCOTT	MA	01907	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 01864	324 MASSACHUSETTS AVE	ARLINGTON	MA	02474-8306	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 10824	430 BROADWAY	REVERE	MA	02151	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 01871	22 LANGLEY ROAD #28	NEWTON CENTER	MA	02459	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 01855	15 SCHOOL STREET	FRAMINGHAM	MA	01701	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02011	446 BOSTON RD	BILLERICA	MA	01821	11/27/2012	11/27/2012	11/16/2022	11/21/2022
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02330	1101 BEACON ST	NEWTON	MA	02461	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02063	29 NEW DERBY STREET	SALEM	MA	01970	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02208	35 MAIN ST	PEABODY	MA	01960	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02309	175 MAIN ST	WOBURN	MA	01801	11/27/2012	11/27/2012	01/23/2020	08/23/2020
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06739	54 PLAIN ST	LOWELL	MA	01851-4419	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #11505	217 DANIEL WEBSTER	NASHUA	NH	03060-5503	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02577	1228 BROADWAY	SAUGUS	MA	01906	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02760	343 BROADWAY	SOMERVILLE	MA	02145	11/27/2012	11/27/2012	04/01/2019	04/01/2019
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02669	20 WESTON STREET	WALTHAM	MA	02453	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02759	550 ADAMS ST SUITE 6	QUINCY	MA	02169	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02861	653 WORCESTER RD STE 3	FRAMINGHAM	MA	01701	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02716	21 JOYCE ST	LYNN	MA	01902	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02977	1101 MAIN STREET	BROCKTON	MA	02301	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02933	841 BOYLSTON STREET	BOSTON	MA	02116	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02945	16 BEACON ST	SOMERVILLE	MA	02143	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03016	416 WARREN ST	ROXBURY	MA	02119	11/27/2012	11/27/2012	01/31/2024	02/20/2024
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03135	825 MORTON STREET	BOSTON	MA	02126	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 02325	290 BROADWAY	LYNN	MA	01904	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03062	595 WASHINGTON ST.	CANTON	MA	02021	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03130	185 CENTRE STREET	MALDEN	MA	02148	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03508	572 MAIN ST	WAKEFIELD	MA	01880	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03496	317 FERRY ST	EVERETT	MA	02149	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS # 04118	735 CHIEF JUSTICE CUSHING HIGHWAY	COHASSET	MA	02025	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03759	1010 BROADWAY	CHELSEA	MA	02150	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03548	225 MAIN ST.	STONEHAM	MA	02180	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03564	99 HARVARD ST.	BROOKLINE	MA	02446	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03758	610 PLEASANT ST.	BROCKTON	MA	02301-2513	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04404	771 CENTRE ST.	BROCKTON	MA	02302	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04072	1890 COLUMBUS AVE	ROXBURY	MA	02119	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03112	1425 MASSACHUSETTS AVE.	ARLINGTON	MA	02476	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04403	418 QUINCY AVENUE	QUINCY	MA	02169	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04535	170 N MAIN STREET	RANDOLPH	MA	02368	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 03251	15 MAIN ST.	WALTHAM	MA	02453	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04729	951 BOSTON PROVIDENCE TPKE	NORWOOD	MA	02062	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04393	54 ELLIOTT STREET	BEVERLY	MA	01915	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04966	215 BEACH ST	MALDEN	MA	02148	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05075	2341 MAIN ST	TEWKSBURY	MA	01876	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 04923	1999 CENTRE ST	WEST ROXBURY	MA	02132	11/27/2012	11/27/2012	11/06/2024	11/18/2024
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06072	1603 WASHINGTON ST	BOSTON	MA	02118	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05687	1324 BEACON ST	BROOKLINE	MA	02446	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05586	1 PLYMOUTH ST	HOLBROOK	MA	02343	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06349	585 WASHINGTON ST	DORCHESTER	MA	02124-2032	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06767	625 MASSACHUSETTS AVE	CAMBRIDGE	MA	02139-3301	11/27/2012	11/27/2012	03/27/2025	03/27/2025
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06470	750 WASHINGTON ST	WEYMOUTH	MA	02188	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06850	1103 KEMPTON STREET	NEW BEDFORD	MA	02740-1530	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06226	220 HUTTLESTON AVE	FAIRHAVEN	MA	02719-1959	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 06805	130 BOWDOIN ST	DORCHESTER	MA	02122-1837	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 05756	1 CENTRAL SQ	EAST BOSTON	MA	02128	11/27/2012	11/27/2012		04/30/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07189	1630 TREMONT STREET	ROXBURY	MA	02120	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07813	25 OAK ST EXTENSION	BROCKTON	MA	02301-1110	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 09319	49 STATION LANDING	MEDFORD	MA	02155	11/27/2012	11/27/2012	01/11/2022	01/12/2022
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 09660	5 HARNDEN STREET	READING	MA	01867	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 09538	2275 WASHINGTON ST	ROXBURY	MA	02119-3212	11/27/2012	11/27/2012	11/08/2022	11/23/2022
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 09405	969 MAIN ST	WEYMOUTH	MA	02190	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #10375	2968 ACUSHNET AVE	NEW BEDFORD	MA	02745-3620	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #10269	32 MAIN ST	LAKEVILLE	MA	02347	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS SPECIALTY PHARMACY#10996	429 BROOKLINE AVENUE	BOSTON	MA	02215	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #02471	166 WALNUT ST	SAUGUS	MA	01906-1976	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #10342	897 MAIN ST	MELROSE	MA	02176	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #10650	880 N MONTELLO ST	BROCKTON	MA	02301-1655	11/27/2012	11/27/2012	04/13/2018	04/13/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #10272	392 BEDFORD ST	WHITMAN	MA	02382-1822	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #10256	1140 N. MAIN ST.	PROVIDENCE	RI	02904-1819	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #10562	4 CENTRAL SQUARE	BRIDGEWATER	MA	02324	11/27/2012	11/27/2012		03/28/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #11499	158 MAIN ST	NORTH READING	MA	01864-3116	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #01917	983 PROVIDENCE HWY	DEDHAM	MA	02026	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #12323	11 MAIN ST	MAYNARD	MA	01754	11/27/2012	11/27/2012	01/26/2016	02/01/2016
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #10685	3 LIBERTY LANE	NORFOLK	MA	02056	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #11831	324 HANCOCK STREET	QUINCY	MA	02171-2258	11/27/2012	11/27/2012	02/27/2025	03/11/2025
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #13081	399 WASHINGTON ST	NEWTON	MA	02458	11/27/2012	11/27/2012	09/26/2018	10/19/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #15390	24 SCHOOL STREET	BOSTON	MA	02108	07/12/2013	10/01/2013		07/12/2013
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #15468	620 WASHINGTON ST	BOSTON	MA	02111	01/08/2015	04/01/2015	07/24/2020	08/23/2020
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #18091	530 SOMERVILLE AVE	SOMERVILLE	MA	02143	04/11/2018	07/01/2018	01/01/2021	01/13/2021
Contract Detail	WALGREEN EASTERN CO., INC.	RITE AID #10148	100 CAMBRIDGE ST SUITE 102	BOSTON	MA	02114	04/11/2018	07/01/2018	07/19/2018	11/02/2018
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17531	343 BROADWAY	SOMERVILLE	MA	02145	04/11/2018	07/01/2018		04/11/2018
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17165	1740 MASSACHUSETTS AVE	CAMBRIDGE	MA	02138	04/11/2018	07/01/2018	01/01/2021	01/25/2021
Contract Detail	WALGREEN EASTERN CO., INC.	RITE AID #10153	971 BENNINGTON ST	EAST BOSTON	MA	02128	04/11/2018	07/01/2018	06/21/2018	11/02/2018
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17685	14 MCGRATH HWY STE 3	SOMERVILLE	MA	02143	04/11/2018	07/01/2018	11/06/2023	11/21/2023
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #19487	330 RIVER ST	CAMBRIDGE	MA	02139	04/11/2018	07/01/2018		04/11/2018
Contract Detail	WALGREEN EASTERN CO., INC.	RITE AID #10162	393 HIGHLAND AVE	SOMERVILLE	MA	02144	04/11/2018	07/01/2018	02/10/2020	05/06/2020
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #17728	405 BROADWAY	EVERETT	MA	02149	07/17/2018	10/01/2018		10/01/2018
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #19067	1329 HYDE PARK AVE	HYDE PARK	MA	02136	07/17/2018	10/01/2018	11/09/2022	11/21/2022
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17169	710 E BROADWAY	SOUTH BOSTON	MA	02127	07/17/2018	10/01/2018		10/01/2018
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #17257	90 RIVER ST STE 7	MATTAPAN	MA	02126	07/17/2018	10/01/2018	11/10/2022	11/21/2022
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #19536	467 SALEM ST	MEDFORD	MA	02155-3336	07/17/2018	10/01/2018		10/01/2018
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS #18361	132 GRANITE ST	QUINCY	MA	02169	10/19/2018	10/01/2018		10/22/2018
Contract Detail	WALGREEN EASTERN CO., INC.	DBA: WALGREENS #19437	1100 DORCHESTER AVE	DORCHESTER	MA	02125	10/19/2018	10/01/2018		10/22/2018
Contract Detail	WALGREEN EASTERN CO., INC.	WALGREENS SPECIALTY PHARMACY #21179	25 MERRIMACK ST.	LOWELL	MA	01852	07/09/2024	10/01/2024		10/01/2024
Contract Detail	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	01/17/2023	04/01/2023	07/03/2024	07/09/2024
Contract Detail	Walgreens Central Fill #21400	44 Cabot Blvd.		Mansfield	MA	02048	10/13/2024	01/01/2025		01/01/2025
Contract Detail	WALGREENS MAIL SERVICE, INC.	8350 S RIVER PARKWAY		TEMPE	AZ	85284	11/27/2012	11/27/2012	10/16/2017	10/19/2018
Contract Detail	WALGREENS MAIL SERVICE, INC.		8337 S PARK CIRCLE	ORLANDO	FL	32819-9049	04/11/2013	07/01/2013	01/26/2016	02/01/2016
Contract Detail	WALGREENS MAIL SERVICE, LLC	WALGREENS MAIL SERVICE #03397	8350 S RIVER PARKWAY	TEMPE	AZ	85284	10/16/2017	01/01/2018	07/03/2024	07/09/2024
Contract Detail	WALGREENS.COM, INC.	DBA: WALGREENS	2225 S. PRICE ROAD	CHANDLER	AZ	85286	10/16/2017	01/01/2018	09/26/2018	10/19/2018

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH220116A	Child	DSH	TUFTS MEDICAL CENTER	South Boston Day Hospital	58 Old Colony Ave	South Boston	MA	Terminated
DSH220116B	Child	DSH	TUFTS MEDICAL CENTER	Kidney and Blood Pressure Clinic	35 Kneeland Street	BOSTON	MA	Active
DSH220116C	Child	DSH	TUFTS MEDICAL CENTER	TUFTS MEDICAL CENTER CANCER CENTER - Hematology / Oncology Clinic	41 MONTVALE AVE	STONEHAM	MA	Active
DSH220116D	Child	DSH	TUFTS MEDICAL CENTER	TUFTS MEDICAL CENTER, INC - Tufts Medical Center Cancer Center - Infusion Center	41 MONTVALE AVE	STONEHAM	MA	Active
DSH220116E	Child	DSH	TUFTS MEDICAL CENTER	Tufts Medical Center (Neurology - Medford) - Neurology	170 Governors Ave	Medford	MA	Active
DSH220116F	Child	DSH	TUFTS MEDICAL CENTER	Tufts Medical Center Gastrointestinal Stoneham - Gastrointestinal	51 Montvale Ave	Stoneham	MA	Active
DSH220116G	Child	DSH	TUFTS MEDICAL CENTER	Tufts Medical Center Rheumatology Reading - Rheumatology	30 New Crossing Road	Reading	MA	Active
DSH220116H	Child	DSH	TUFTS MEDICAL CENTER	Tufts Medical Center (Endocrine / Diabetes - Medford) - Endocrine, Diabetes	170 Governors Ave	Medford	MA	Active
DSH220116J	Child	DSH	TUFTS MEDICAL CENTER	Tufts Medical Center (Endocrine/Diabetes) - Melrose - Endocrine/Diabetes	585 Lebanon Street	Melrose	MA	Active
DSH220116K	Child	DSH	TUFTS MEDICAL CENTER	TUFTS MEDICAL CENTER FRAMINGHAM - Infusion Center	99 LINCOLN ST	FRAMINGHAM	MA	Active
DSH220116L	Child	DSH	TUFTS MEDICAL CENTER	TUFTS MEDICAL CENTER FRAMINGHAM - Hematology / Oncology Clinic	99 LINCOLN ST	FRAMINGHAM	MA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Shipping Address	Insert	Change Request		Tufts Medical Center - Loading Dock 25 Harvard Street Boston, MA 02111	8/21/2024 10:12 AM
Details	Last Recertification Date	Update	Recertification	8/25/2023 9:02:14 AM	8/13/2024 8:22:55 AM	8/13/2024 8:22 AM
Contacts	Authorizing Official	Update	AO Change Request	Siddiqi, Assad Senior Vice President of Finance Tufts Medical Center 6176367767	bennett, kevin michael SVP, Finance Tufts Medical Center 6176362533	8/12/2024 4:44 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1508948613	10/16/2023 2:43 PM
Medicaid Billing	NPI: State	Insert	Change Request		CT	10/16/2023 2:43 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1508948613	10/16/2023 2:43 PM
Medicaid Billing	NPI: State	Insert	Change Request		NY	10/16/2023 2:43 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1508948613	10/16/2023 2:43 PM
Medicaid Billing	NPI: State	Insert	Change Request		VT	10/16/2023 2:43 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1508948613	10/16/2023 2:43 PM
Medicaid Billing	NPI: State	Insert	Change Request		RI	10/16/2023 2:43 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1508948613	10/16/2023 2:43 PM
Medicaid Billing	NPI: State	Insert	Change Request		NH	10/16/2023 2:43 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1508948613	10/16/2023 2:43 PM
Medicaid Billing	NPI: State	Insert	Change Request		ME	10/16/2023 2:43 PM
Addresses	Shipping Address	Delete	Recertification	New England Life Care d.b.a. Advanced Compounding Solutions 4 Constitution Way Suite L Woburn, MA 01801		8/25/2023 9:02 AM
Details	Last Recertification Date	Update	Recertification	9/13/2022 11:00:16 AM	8/25/2023 9:02:14 AM	8/25/2023 9:02 AM
Contacts	Primary Contact	Update	PC Change Request	Thompson, Ross VP, Clinical Operations Tufts Medical Center 6176364663	Calamari, Joan Marie Director of Pharmacy Tufts Medical Center 6178770552	8/11/2023 10:35 AM
Medicaid Billing	NPI: Number	Insert	Group Change Request		1508948613	4/14/2023 12:22 PM
Medicaid Billing	NPI: State	Insert	Group Change Request		MA	4/14/2023 12:22 PM
Details	Last Recertification Date	Update	Recertification	8/30/2021 11:42:29 AM	9/13/2022 11:00:16 AM	9/13/2022 11:00 AM
Contacts	Primary Contact	Update	Profile Change Request	Thompson, Ross Director of Pharmacy Tufts Medical Center 6176368981	Thompson, Ross VP, Clinical Operations Tufts Medical Center 6176364663	9/1/2022 11:41 AM
Contacts	Authorizing Official	Update	AO Change Request	Hanscom, Kristine CFO Tufts Medical Center 6176367767	Siddiqi, Assad Senior Vice President of Finance Tufts Medical Center 6176367767	6/3/2022 11:16 AM
Details	Last Recertification Date	Update	Recertification	8/24/2020 6:31:38 AM	8/30/2021 11:42:29 AM	8/30/2021 11:42 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		003032570	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		CT	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		0220116	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		RI	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		110020611G	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MA	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		110020611D	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MA	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		01608240	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		NY	7/12/2021 5:42 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	110020611 (MA)		7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1730132515	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		CT	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1053350306	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		CT	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1851337141	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		CT	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1730132515	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		VT	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1053350306	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		VT	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1851337141	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		VT	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1730132515	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		NH	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1053350306	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		NH	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1851337141	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		NH	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1730132515	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		RI	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1053350306	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		RI	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1851337141	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		RI	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1053350306	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		MA	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1851337141	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		MA	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1730132515	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		NY	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1053350306	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		NY	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1851337141	7/12/2021 5:42 PM
Medicaid Billing	NPI: State	Insert	Change Request		NY	7/12/2021 5:42 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1508948613 (MA)		7/12/2021 5:42 PM
Addresses	Shipping Address	Insert	Change Request		New England Life Care d.b.a. Advanced Compounding Solutions 4 Constitution Way Suite L Woburn, MA 01801	6/9/2021 4:43 PM
Addresses	Shipping Address	Insert	Change Request		Tufts Medical Center - Blood Bank 800 Washington Street Proger 8th Floor Boston, MA 02111	10/5/2020 9:42 AM
Addresses	Shipping Address	Insert	Change Request		Tufts Medical Center 800 Washington Street Boston, MA 02111	10/5/2020 9:42 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		OP20116	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		RI	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		003079789	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		CT	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		0220116	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		VT	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		3071222	8/24/2020 6:31 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		NH	8/24/2020 6:31 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1730132515	8/24/2020 6:31 AM
Medicaid Billing	NPI: State	Insert	Recertification		ME	8/24/2020 6:31 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1851337141	8/24/2020 6:31 AM
Medicaid Billing	NPI: State	Insert	Recertification		ME	8/24/2020 6:31 AM
Medicaid Billing	NPI: Number	Insert	Recertification		1053350306	8/24/2020 6:31 AM
Medicaid Billing	NPI: State	Insert	Recertification		ME	8/24/2020 6:31 AM
Medicaid Billing	NPI: State	Update	Recertification		MA	8/24/2020 6:31 AM
Medicaid Billing	NPI: State	Update	Recertification		MA	8/24/2020 6:31 AM
Details	Last Recertification Date	Update	Recertification	9/5/2019 11:42:46 AM	8/24/2020 6:31:38 AM	8/24/2020 6:31 AM
Details	Last Recertification Date	Update	Recertification	8/27/2018 9:30:19 AM	9/5/2019 11:42:46 AM	9/5/2019 11:42 AM
Details	Last Recertification Date	Update	Recertification	11/29/2017 3:49:24 PM	8/27/2018 9:30:19 AM	8/27/2018 9:30 AM
Details	Last Recertification Date	Update	Recertification	8/24/2016 12:00:00 AM	11/29/2017 3:49:24 PM	11/29/2017 3:49 PM
Contacts	Authorizing Official	Update		Hanscom, Kristine CFO 6176367767	Hanscom, Kristine CFO Tufts Medical Center 6176367767	10/16/2017 8:44 AM
Contacts	Primary Contact	Update		Thompson, Ross Director of Pharmacy 6176368981	Thompson, Ross Director of Pharmacy Tufts Medical Center 6176368981	10/5/2017 2:23 PM
Contacts	Authorizing Official	Insert			Hanscom, Kristine CFO 6176367767	7/18/2017 8:51 AM
Addresses	Main Address	Insert			800 WASHINGTON STREET BOSTON, MA 02111	8/24/2016 10:31 AM
Contacts	Primary Contact	Insert			Thompson, Ross Director of Pharmacy 6176368981	8/24/2016 10:31 AM
Details	Last Recertification Date	Update		8/5/2015 12:00:00 AM	8/24/2016 12:00:00 AM	8/24/2016 10:31 AM
Details	Last Recertification Date	Update		8/11/2014 12:00:00 AM	8/5/2015 12:00:00 AM	8/5/2015 4:43 PM
Details	Last Recertification Date	Update		9/5/2013 12:00:00 AM	8/11/2014 12:00:00 AM	8/11/2014 9:52 AM
Medicaid Billing	Medicaid: Is Primary	Update		True	False	9/5/2013 6:02 AM
Medicaid Billing	Medicaid: Number	Update		0404306	110020611	9/5/2013 6:02 AM
Details	Last Recertification Date	Update		7/1/2012 12:00:00 AM	9/5/2013 12:00:00 AM	9/5/2013 6:02 AM
Medicaid Billing	NPI: Number	Insert			1730132515	6/5/2012 5:53 PM
Medicaid Billing	NPI: Number	Insert			1508948613	5/16/2012 7:46 AM
Details	Last Recertification Date	Update			7/1/2012 12:00:00 AM	5/16/2012 7:46 AM
Dates	Participating Approval Date	Update		5/2/2008 2:59:07 PM	5/2/2008 12:00:00 AM	12/23/2011 9:48 AM
Details	Comments Public	Insert			5/2/08 ENT NAME CHANGE (WAS NEW ENGLAND MEDICAL CENTER), ADDR CHANGE (WAS 750-755 WASHINGTON STREET) 12/23/11 change Ao and PC from Burke and GOUVEIA to Agba and Thompson JH	12/23/2011 9:48 AM
Details	Last Recertification Date	Insert				5/2/2008 3:02 PM
Details	Grant Number	Insert				5/2/2008 3:02 PM
Details	340B ID	Insert			DSH220116	5/2/2008 3:02 PM
Details	Is Authorizing Official EHB Data	Insert				5/2/2008 3:02 PM
Dates	Last Date That 340B Drugs Purchased	Insert				5/2/2008 3:02 PM
Details	Medicare Provider Number	Insert			220116	5/2/2008 3:02 PM
Details	Entity Name	Insert			TUFTS MEDICAL CENTER	5/2/2008 3:02 PM
Details	Program Code	Insert			DSH	5/2/2008 3:02 PM
Details	Entity Subname	Insert				5/2/2008 3:02 PM
Dates	Participating Approval Date	Insert			5/2/2008 2:59:07 PM	5/2/2008 3:02 PM
Details	State	Insert			Active	5/2/2008 3:02 PM
Dates	Registration Date	Insert			5/2/2008 12:00:00 AM	5/2/2008 3:02 PM
Dates	Signed By Date	Insert				5/2/2008 3:02 PM
Dates	Start Date	Insert			10/1/2003 12:00:00 AM	5/2/2008 3:02 PM
Terminations	Termination Comments	Insert				5/2/2008 3:02 PM
Terminations	Termination Date	Insert				5/2/2008 3:02 PM
Terminations	Termination Effective Date	Insert				5/2/2008 3:02 PM
Terminations	Termination Reason	Insert				5/2/2008 3:02 PM
Details	Comments Public	Insert			5/2/08 ENT NAME CHANGE (WAS NEW ENGLAND MEDICAL CENTER), ADDR CHANGE (WAS 750-755 WASHINGTON STREET)	5/2/2008 3:02 PM
Medicaid Billing	Medicaid: Is Primary	Insert			True	5/2/2008 3:02 PM
Medicaid Billing	Medicaid: Number	Insert			0404306	5/2/2008 3:02 PM
Medicaid Billing	Medicaid: State	Insert			MA	5/2/2008 3:02 PM