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DSH220071 MASSACHUSETTS GENERAL HOSPITAL (Active)
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Main Details
Name
MASSACHUSETTS GENERAL HOSPITAL
Subdivision Name
The General Hospital Corporation
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH220071
Medicare Provider Number
220071
Additional Details
Current Program Status
Active
Registration Date
3/11/2021
Participating Start Date
3/24/2021
Participating Approval Date
3/17/2021
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Mass General Hospital
Sally Mason Boemer, Senior Vice President of Finance
(617) 724-4537
Primary Contact
Massachusetts General Hospital
Rafic Nehme, Director, Pharmacy Business & Finance
(617) 726-5125
Addresses
Street Address
55 FRUIT STREET
BOSTON, MA 02114
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2017, terminated 1/1/2020. Reinstated 4/1/2021.
03/17/2021
May 2025
May 2025
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