340B Drug Pricing Program Database
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DSH220052AE BROCKTON HOSPITAL, INC (Active)
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Main Details
Name
BROCKTON HOSPITAL, INC
Subdivision Name
BH Raynham Eye Services - Eye Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220052AE
Medicare Provider Number
220052
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/3/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/11/2024
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Brockton Hospital
Margaret Clapp, Enterprise Director of Pharmacy
(508) 941-7750
Primary Contact
Signature Healthcare Brockton Hospital
Christine Canty, 340B Business Operations Manager
(508) 941-7186
Addresses
Street Address
1215 Broadway
Raynham, MA 02767
Billing Address
Signature Healthcare Brockton Hospital, Inc.
680 Centre Street
Brockton, MA 02302
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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