340B Drug Pricing Program Database
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DSH220001F HealthAlliance-Clinton Hospital (Active)
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Main Details
Name
HealthAlliance-Clinton Hospital
Subdivision Name
Leominster Urgent Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220001F
Medicare Provider Number
220001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/8/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/17/2016
Last Recertification Date
8/27/2024
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
510 North Main Street
Leominster, MA 01453
Billing Address
HealthAlliance-Clinton Hospital
60 Hospital Road
Leominster, MA 01453
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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