340B Drug Pricing Program Database

Name

SOUTHCOAST HOSPITALS GROUP, INC.

Subdivision Name

DBA TOBEY HOSPITAL

Type

Disproportionate Share Hospital

Rural

No

340B ID

DSH220074E

Medicare Provider Number

220074

Outpatient Facility Provider Number

Current Program Status

Terminated

Registration Date

4/23/2008

Participating Start Date

10/1/2004

Participating Approval Date

4/23/2008

Last Recertification Date

11/7/2017

Termination Date
Termination Reason

4/1/2018
Other

Authorizing Official

Southcoast Health
Renee Clark, Exec. Vice President & Chief Operating Officer
(508) 973-5872

Primary Contact

Southcoast Hospitals Group
Jillian Anderson, Manager - 340B Program & Supply Chain
(508) 973-5951

Street Address

43 HIGH STREET
WAREHAM, MA 02571

Billing Address

Southcoast Hospitals Group, Inc.
200 Mill Road, Suite 230
Fairhaven, MA 02719