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DSH220001C HealthAlliance-Clinton Hospital (Active)
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Main Details
Name
HealthAlliance-Clinton Hospital
Subdivision Name
Infusion Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220001C
Medicare Provider Number
220001
Outpatient Facility Provider Number
220001
Additional Details
Current Program Status
Active
Registration Date
7/11/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/8/2014
Last Recertification Date
8/12/2024
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
275 Nichols Road
Fitchburg, MA 01420
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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