340B Drug Pricing Program Database
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DSH220001H HealthAlliance-Clinton Hospital (Active)
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Main Details
Name
HealthAlliance-Clinton Hospital
Subdivision Name
HAH FITCHBURG FAMILY PRACTICE - Diabetes
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220001H
Medicare Provider Number
220001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/10/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/22/2024
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Marlborough Hospital
Steven McCue, Chief Financial Officer
(508) 486-5804
Primary Contact
UMass Memorial HealthAlliance-Clinton Hospital
Richard Bautz, Director of Pharmacy
(774) 437-3741
Addresses
Street Address
326 NICHOLS RD
FL 1
FITCHBURG, MA 01420-1914
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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