340B Drug Pricing Program Database
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DSH220077AX BAYSTATE MEDICAL CENTER (Approved)
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Main Details
Name
BAYSTATE MEDICAL CENTER
Subdivision Name
BAYSTATE INFUSION CENTER NOBLE HOSP - Baystate Infusion - Noble Sat
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH220077AX
Medicare Provider Number
220077
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/7/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/8/2025
Last Recertification Date
Contacts
Authorizing Official
Baystate Health
Raymond P McCarthy, SVP, Chief Financial Officer & Treasurer
(413) 794-3290
Primary Contact
Baystate Health
Nancy Cruz, Pharmacy Compliance Manager
(413) 794-8282
Addresses
Street Address
115 W SILVER ST
3RD FLOOR
WESTFIELD, MA 01085-3678
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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