No
Contract Detail | CAPE COD HEALTHCARE PHARMACY AT CCH | 27 PARK ST |
| HYANNIS | MA | 02601-5230 | 02/18/2020 | 04/01/2020 | | | 04/01/2020 |
Contract Detail | CAPE COD HEALTHCARE PHARMACY AT FALMOUTH | 100 TER HEUN DR |
| FALMOUTH | MA | 02540-2503 | 02/18/2020 | 04/01/2020 | | | 04/01/2020 |
Contract Detail | OSCO PHARMACY #7596 | |
18 SISSON ROAD
| HARWICHPORT | MA | 02646 | 04/14/2023 | 07/01/2023 | | 04/17/2023 | 04/17/2023 |
Contract Detail | STAR MARKETS COMPANY INC | STAR MARKET PHARMACY #4596 |
18 SISSON ROAD
| HARWICH PORT | MA | 02646 | 04/17/2023 | 07/01/2023 | | | 07/01/2023 |
Details | Last Recertification Date | Update | Recertification | 2/7/2024 9:55:40 AM | 2/20/2025 3:18:02 PM | 2/20/2025 3:18 PM |
Contacts | Primary Contact | Update | Recertification | Hand, Kevin
Assistant Controller
Cape Cod Healthcare
7744705542 | Hand, Kevin
Corporate Controller
Cape Cod Healthcare
7744705542 | 2/20/2025 3:17 PM |
Details | Last Recertification Date | Update | Recertification | 2/7/2023 4:18:35 PM | 2/7/2024 9:55:40 AM | 2/7/2024 9:55 AM |
Details | NOFO Number | Update | | HRSA-22-014 | | 12/16/2023 10:34 AM |
Details | Assistance Received From Date | Update | Recertification | 4/1/2018 12:00:00 AM | 4/1/2022 12:00:00 AM | 2/7/2023 4:18 PM |
Details | Assistance Received To Date | Update | Recertification | 3/31/2022 12:00:00 AM | 3/31/2025 12:00:00 AM | 2/7/2023 4:18 PM |
Details | Last Recertification Date | Update | Recertification | 2/4/2022 10:06:48 AM | 2/7/2023 4:18:35 PM | 2/7/2023 4:18 PM |
Details | NOFO Number | Update | Recertification | HRSA-18-004 | HRSA-22-014 | 2/7/2023 4:18 PM |
Medicaid Billing | Medicaid: Number | Delete | Recertification | 110108134 (MA) | | 2/4/2022 10:06 AM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1457713232 (MA) | | 2/4/2022 10:06 AM |
Medicaid Billing | NPI: Number | Delete | Recertification | 1588101380 (MA) | | 2/4/2022 10:06 AM |
Details | Last Recertification Date | Update | Recertification | 2/25/2021 6:56:41 AM | 2/4/2022 10:06:48 AM | 2/4/2022 10:06 AM |
Contacts | Primary Contact | Update | Change Request | Fuller, Scott
Executive Director - Revenue, Finance, & Reimbursement
Cape Cod Healthcare
7744705535 | Hand, Kevin
Assistant Controller
Cape Cod Healthcare
7744705542 | 5/18/2021 1:27 PM |
Medicaid Billing | Medicaid: Is Primary | Insert | Recertification | | False | 2/25/2021 6:56 AM |
Medicaid Billing | Medicaid: Number | Insert | Recertification | | 110108134 | 2/25/2021 6:56 AM |
Medicaid Billing | Medicaid: State | Insert | Recertification | | MA | 2/25/2021 6:56 AM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1457713232 | 2/25/2021 6:56 AM |
Medicaid Billing | NPI: State | Insert | Recertification | | MA | 2/25/2021 6:56 AM |
Medicaid Billing | NPI: Number | Insert | Recertification | | 1588101380 | 2/25/2021 6:56 AM |
Medicaid Billing | NPI: State | Insert | Recertification | | MA | 2/25/2021 6:56 AM |
Details | Assistance Received From Date | Update | Recertification | | 4/1/2018 12:00:00 AM | 2/25/2021 6:56 AM |
Details | Assistance Received To Date | Update | Recertification | | 3/31/2022 12:00:00 AM | 2/25/2021 6:56 AM |
Details | Last Recertification Date | Update | Recertification | | 2/25/2021 6:56:41 AM | 2/25/2021 6:56 AM |
Details | NOFO Number | Update | Recertification | | HRSA-18-004 | 2/25/2021 6:56 AM |
Details | State | Update | | Approved | Active | 4/1/2020 12:05 AM |
Contacts | Signed By | Insert | New Registration | | Al-Hachem, Valerie Nicole
Infectious Disease Director & Grants Administrator
Cape Cod Hospital - Infectious Disease Clinical Services
5088625639 | 2/18/2020 11:01 AM |
Details | 340B ID | Update | New Registration | | HV02601A | 2/18/2020 11:01 AM |
Dates | Participating Approval Date | Update | New Registration | | 2/18/2020 11:01:39 AM | 2/18/2020 11:01 AM |
Details | State | Update | New Registration | Pending | Approved | 2/18/2020 11:01 AM |
Dates | Signed By Date | Update | New Registration | | 1/15/2020 4:17:53 PM | 2/18/2020 11:01 AM |
Dates | Start Date | Update | New Registration | | 4/1/2020 12:00:00 AM | 2/18/2020 11:01 AM |
Addresses | Main Address | Insert | New Registration | |
100 Ter Heun Drive
Falmouth, MA 02540 | 1/15/2020 4:17 PM |
Addresses | Billing Address | Insert | New Registration | | CAPE COD HOSPITAL
27 PARK STREET
HYANNIS, MA 02601 | 1/15/2020 4:17 PM |
Contacts | Primary Contact | Insert | New Registration | | Fuller, Scott
Executive Director - Revenue, Finance, & Reimbursement
Cape Cod Healthcare
7744705535 | 1/15/2020 4:17 PM |
Contacts | Authorizing Official | Insert | New Registration | | Al-Hachem, Valerie Nicole
Infectious Disease Director & Grants Administrator
Cape Cod Hospital - Infectious Disease Clinical Services
5088625639 | 1/15/2020 4:17 PM |
Details | Last Recertification Date | Insert | New Registration | | | 1/15/2020 4:17 PM |
Details | Grant Number | Insert | New Registration | | H76HA00764 | 1/15/2020 4:17 PM |
Details | 340B ID | Insert | New Registration | | | 1/15/2020 4:17 PM |
Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 1/15/2020 4:17 PM |
Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 1/15/2020 4:17 PM |
Details | Medicare Provider Number | Insert | New Registration | | | 1/15/2020 4:17 PM |
Details | Entity Name | Insert | New Registration | | CAPE COD HOSPITAL | 1/15/2020 4:17 PM |
Details | Program Code | Insert | New Registration | | HV | 1/15/2020 4:17 PM |
Details | Entity Subname | Insert | New Registration | | Ryan White Part C Outpatient EIS Program at Falmouth Hospital | 1/15/2020 4:17 PM |
Dates | Participating Approval Date | Insert | New Registration | | | 1/15/2020 4:17 PM |
Details | State | Insert | New Registration | | Pending | 1/15/2020 4:17 PM |
Dates | Registration Date | Insert | New Registration | | 1/15/2020 4:17:48 PM | 1/15/2020 4:17 PM |
Dates | Signed By Date | Insert | New Registration | | | 1/15/2020 4:17 PM |
Dates | Start Date | Insert | New Registration | | | 1/15/2020 4:17 PM |
Terminations | Termination Comments | Insert | New Registration | | | 1/15/2020 4:17 PM |
Terminations | Termination Date | Insert | New Registration | | | 1/15/2020 4:17 PM |
Terminations | Termination Effective Date | Insert | New Registration | | | 1/15/2020 4:17 PM |
Terminations | Termination Reason | Insert | New Registration | | | 1/15/2020 4:17 PM |