340B Drug Pricing Program Database
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DSH220052T BROCKTON HOSPITAL, INC (Active)
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Main Details
Name
BROCKTON HOSPITAL, INC
Subdivision Name
Signature Healthcare Brockton Hospital –Nephrology Clinic Liberty - BH Nephr Clinic Liberty
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220052T
Medicare Provider Number
220052
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
5/18/2021
Participating Start Date
5/20/2021
Participating Approval Date
5/20/2021
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Brockton Hospital
Margaret Clapp, Enterprise Director of Pharmacy
(508) 941-7750
Primary Contact
Signature Healthcare Brockton Hospital
Christine Canty, 340B Business Operations Manager
(508) 941-7186
Addresses
Street Address
110 Liberty St
2nd Floor
Brockton, MA 02301
Billing Address
Signature Healthcare Brockton Hospital Inc.
680 Centre Street
Brockton, MA 02302
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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