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DSH220011 CAMBRIDGE PUBLIC HEALTH COMMISSION (Active)
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Main Details
Name
CAMBRIDGE PUBLIC HEALTH COMMISSION
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220011
Medicare Provider Number
220011
Additional Details
Current Program Status
Active
Registration Date
7/1/1998
Participating Start Date
7/1/1998
Participating Approval Date
7/22/2004
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
1493 Cambridge Street
CAMBRIDGE, MA 02139
Billing Address
Cambridge Public Health Commission
100 Cummings Park
Woburn, MA 01801
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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CORRECTED CONTACT NAME, 11/16/05 - CHANGED ID# FROM DSH11559 TO DSH220011
07/01/1998
June 2025
June 2025
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