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DSH220163CT UMASS MEMORIAL MEDICAL CENTER (Active)
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Main Details
Name
UMASS MEMORIAL MEDICAL CENTER
Subdivision Name
Marlborough Cancer Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH220163CT
Medicare Provider Number
220163
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/9/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/14/2015
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
UMass Memorial Medical Center
Alice Shakman, Vice President Operations
(774) 443-0540
Primary Contact
UMass Memorial Medical Center
Meetali Desai, 340B Compliance Specialist
(774) 443-2852
Addresses
Street Address
157 Union Street
Marlborough, MA 01752
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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