Covered Entity Details

DSH220019L UMass Memorial Health - Harrington Hospital, Inc. (Active) - information as of 4/28/2025 12:44:25 AM

Main Details

Name

UMass Memorial Health - Harrington Hospital, Inc.

Subdivision Name

HARRINGTON MEMORIAL HOSPITAL, INC. - UMass Memorial Health-Addiction Immediate Care

Type

Disproportionate Share Hospital

Rural

340B ID

DSH220019L

Medicare Provider Number

220019

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/11/2023

Participating Start Date

7/1/2023

Participating Approval Date

5/17/2023

Last Recertification Date

9/9/2024

Contacts

Authorizing Official

UMass Memorial Health-Harrington
Edward Moore, President
(508) 765-3002

Primary Contact

UMass Memorial Health-Harrington
Kristie Reed, Pharmacy Director
(508) 765-3105

Addresses

Street Address

340 THOMPSON RD
WEBSTER, MA 01570-1509

Billing Address

Umass Memorial Health Harrington
100 South St
Southbridge, MA 01550

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

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
CT		1790780047
MA		1790780047
NY		1790780047
NC		1790780047
RI		1790780047

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH220019A	Child	DSH	UMass Memorial Health - Harrington Hospital, Inc.	UMass Memorial Health - Harrington at Webster-Emergency Room	340 THOMPSON RD	WEBSTER	MA	Active
DSH220019B	Child	DSH	HARRINGTON MEMORIAL HOSPITAL	HARRINGTON HEALTHCARE AT HUBBARD / Operating Room	340 THOMPSON RD	WEBSTER	MA	Terminated
DSH220019C	Child	DSH	UMass Memorial Health - Harrington Hospital, Inc.	The Cancer Center at Harrington-Infusion Clinic	55 Sayles Street	Southbridge	MA	Active
DSH220019D	Child	DSH	UMass Memorial Health - Harrington Hospital, Inc.	UMass Memorial Health - Harrington Wound Care Center	10 North Main Street	Charlton	MA	Active
DSH220019E	Child	DSH	HARRINGTON MEMORIAL HOSPITAL	HARRINGTON HEALTHCARE AT HUBBARD / Surigical Day Care	340 THOMPSON RD	WEBSTER	MA	Terminated
DSH220019F	Child	DSH	HARRINGTON MEMORIAL HOSPITAL	HARRINGTON HEALTHCARE AT HUBBARD / Anesthesia	340 THOMPSON RD	WEBSTER	MA	Terminated
DSH220019G	Child	DSH	HARRINGTON MEMORIAL HOSPITAL	HARRINGTON HEALTHCARE AT HUBBARD / Recovery Room	340 THOMPSON RD	WEBSTER	MA	Terminated
DSH220019H	Child	DSH	HARRINGTON MEMORIAL HOSPITAL	Harrington Hospital Outpatient Behavioral Health	161 West Main Stree	Dudley	MA	Terminated
DSH220019J	Child	DSH	UMass Memorial Health - Harrington Hospital, Inc.	UMass Memorial Health - Harrington Behavioral Health Recovery Services	176 Main Street	Southbridge	MA	Terminated
DSH220019K	Child	DSH	UMass Memorial Health - Harrington Hospital, Inc.	UMass Memorial Health - Harrington Mental Health	29 Pine Street	Southbridge	MA	Active
DSH220019L	Child	DSH	UMass Memorial Health - Harrington Hospital, Inc.	HARRINGTON MEMORIAL HOSPITAL, INC. - UMass Memorial Health-Addiction Immediate Care	340 THOMPSON RD	WEBSTER	MA	Active
DSH220019M	Child	DSH	UMass Memorial Health - Harrington Hospital, Inc.	HARRINGTON MEMORIAL HOSPITAL OBH - UMass Memorial Health-Child and Family Mental health	139 SOUTH ST	SOUTHBRIDGE	MA	Active
DSH220019N	Child	DSH	UMass Memorial Health - Harrington Hospital, Inc.	The Cancer Center at Harrington - Oncology Clinic	55 Sayles St	Southbridge	MA	Active
DSH220019P	Child	DSH	UMass Memorial Health - Harrington Hospital, Inc.	Harrington Substance Abuse at Pine St - Substance Abuse	29 Pine St	Southbridge	MA	Active
DSH220019Q	Child	DSH	UMass Memorial Health - Harrington Hospital, Inc.	Harrington Healthcare at Webster - Substance Abuse	340 Thompson Rd	Webster	MA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Billing Address	Insert	Change Request		Umass Memorial Health Harrington 100 South St Southbridge, MA 01550	4/15/2025 1:26 PM
Details	Last Recertification Date	Update	Recertification	8/21/2023 12:33:11 PM	9/9/2024 10:20:56 AM	9/9/2024 10:20 AM
Medicaid Billing	NPI: Number	Delete	Change Request	1790780047 (ME)		6/6/2024 8:13 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	003023603 (CT)		3/28/2024 11:18 AM
Medicaid Billing	Medicaid: Number	Delete	Change Request	110024448c (MA)		3/28/2024 11:18 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1790780047	3/28/2024 11:18 AM
Medicaid Billing	NPI: State	Insert	Change Request		NY	3/28/2024 11:18 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1790780047	3/28/2024 11:18 AM
Medicaid Billing	NPI: State	Insert	Change Request		ME	3/28/2024 11:18 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1790780047	3/28/2024 11:18 AM
Medicaid Billing	NPI: State	Insert	Change Request		NC	3/28/2024 11:18 AM
Medicaid Billing	NPI: Number	Insert	Change Request		1790780047	3/28/2024 11:18 AM
Medicaid Billing	NPI: State	Insert	Change Request		RI	3/28/2024 11:18 AM
Details	Last Recertification Date	Update	Recertification		8/21/2023 12:33:11 PM	8/21/2023 12:33 PM
Details	State	Update		Approved	Active	7/1/2023 12:01 AM
Contacts	Signed By	Insert	New Registration		Moore, Edward President UMass Memorial Health-Harrington 5087653002	5/17/2023 10:21 AM
Details	340B ID	Update	New Registration		DSH220019L	5/17/2023 10:21 AM
Details	Entity Subname	Update	New Registration	HARRINGTON MEMORIAL HOSPITAL, INC.	HARRINGTON MEMORIAL HOSPITAL, INC. - UMass Memorial Health-Addiction Immediate Care	5/17/2023 10:21 AM
Dates	Participating Approval Date	Update	New Registration		5/17/2023 10:21:52 AM	5/17/2023 10:21 AM
Details	State	Update	New Registration	Pending	Approved	5/17/2023 10:21 AM
Dates	Signed By Date	Update	New Registration		4/12/2023 3:12:19 PM	5/17/2023 10:21 AM
Dates	Start Date	Update	New Registration		7/1/2023 12:00:00 AM	5/17/2023 10:21 AM
Addresses	Main Address	Insert	New Registration		340 THOMPSON RD WEBSTER, MA 01570-1509	4/11/2023 11:50 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/11/2023 11:50 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		003023603	4/11/2023 11:50 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		CT	4/11/2023 11:50 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	4/11/2023 11:50 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		110024448c	4/11/2023 11:50 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		MA	4/11/2023 11:50 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1790780047	4/11/2023 11:50 AM
Medicaid Billing	NPI: State	Insert	New Registration		CT	4/11/2023 11:50 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1790780047	4/11/2023 11:50 AM
Medicaid Billing	NPI: State	Insert	New Registration		MA	4/11/2023 11:50 AM
Contacts	Primary Contact	Insert	New Registration		Reed, Kristie Pharmacy Director UMass Memorial Health-Harrington 5087653105	4/11/2023 11:50 AM
Contacts	Authorizing Official	Insert	New Registration		Moore, Edward President UMass Memorial Health-Harrington 5087653002	4/11/2023 11:50 AM
Details	Assistance Received From Date	Insert	New Registration			4/11/2023 11:50 AM
Details	Assistance Received To Date	Insert	New Registration			4/11/2023 11:50 AM
Details	Last Recertification Date	Insert	New Registration			4/11/2023 11:50 AM
Details	Grant Number	Insert	New Registration			4/11/2023 11:50 AM
Details	340B ID	Insert	New Registration			4/11/2023 11:50 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/11/2023 11:50 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/11/2023 11:50 AM
Details	Medicare Provider Number	Insert	New Registration		220019	4/11/2023 11:50 AM
Details	Entity Name	Insert	New Registration		UMass Memorial Health - Harrington Hospital, Inc.	4/11/2023 11:50 AM
Details	NOFO Number	Insert	New Registration			4/11/2023 11:50 AM
Details	Program Code	Insert	New Registration		DSH	4/11/2023 11:50 AM
Details	Entity Subname	Insert	New Registration		HARRINGTON MEMORIAL HOSPITAL, INC.	4/11/2023 11:50 AM
Dates	Participating Approval Date	Insert	New Registration			4/11/2023 11:50 AM
Details	State	Insert	New Registration		Pending	4/11/2023 11:50 AM
Dates	Registration Date	Insert	New Registration		4/11/2023 11:50:30 AM	4/11/2023 11:50 AM
Dates	Signed By Date	Insert	New Registration			4/11/2023 11:50 AM
Dates	Start Date	Insert	New Registration			4/11/2023 11:50 AM
Terminations	Termination Comments	Insert	New Registration			4/11/2023 11:50 AM
Terminations	Termination Date	Insert	New Registration			4/11/2023 11:50 AM
Terminations	Termination Effective Date	Insert	New Registration			4/11/2023 11:50 AM
Terminations	Termination Reason	Insert	New Registration			4/11/2023 11:50 AM