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SCH220177-00 NANTUCKET COTTAGE HOSPITAL (Terminated)
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Main Details
Name
NANTUCKET COTTAGE HOSPITAL
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH220177-00
Medicare Provider Number
220177
Additional Details
Current Program Status
Terminated
Registration Date
1/16/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/26/2024
Last Recertification Date
9/4/2024
Termination Date
Termination Reason
4/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Mass General Brigham
Vincent McDermott, Senior Vice President/CFO
(617) 283-6541
Primary Contact
Massachusetts General Hospital
Rafic Nehme, Director, Pharmacy Business & Finance
(617) 726-5125
Addresses
Street Address
57 PROSPECT STREET
NANTUCKET, MA 02554-2799
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 3/16/2021, terminated 3/15/2022. Reinstated 4/1/2024.
02/26/2024
May 2025
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