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DSH220011AC CAMBRIDGE PUBLIC HEALTH COMMISSION (Active)
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Main Details
Name
CAMBRIDGE PUBLIC HEALTH COMMISSION
Subdivision Name
CHA Everett Care Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220011AC
Medicare Provider Number
220011
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
2/29/2012
Participating Start Date
4/1/2012
Participating Approval Date
3/23/2012
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Cambridge Public Health Commission
Andrew M Fuqua, Senior Vice President and General Counsel
(617) 665-1000
Primary Contact
Cambridge Public Health Commission
Maria Kossilos, Associate Chief Pharmacy Officer
(617) 806-8505
Addresses
Street Address
391 Broadway
Everett, MA 02149
Billing Address
Cambridge Public Health Commission
CHA Outpatient Pharmacy
1493 Cambridge Street
Cambridge, MA 02139
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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