340B Drug Pricing Program Database
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DSH220066F MERCY MEDICAL CENTER (Active)
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Main Details
Name
MERCY MEDICAL CENTER
Subdivision Name
Mercy Medical Center - Multiple Sclerosis Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220066F
Medicare Provider Number
220066
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2021
Participating Start Date
7/1/2021
Participating Approval Date
5/26/2021
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Mercy Medical Center
Robert Roose, Chief Administrative Officer
(413) 748-9302
Primary Contact
Mercy Medical Center
Richard Wojtowicz, Director of Pharmacy
(413) 748-9495
Addresses
Street Address
175 Carew St
Springfield, MA 01104
Billing Address
Mercy Medical Center
271 Carew Street
Springfield, MA 01104
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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