340B Drug Pricing Program Database
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RRC220110-205 BRIGHAM AND WOMENS HOSPITAL (Terminated)
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Main Details
Name
BRIGHAM AND WOMENS HOSPITAL
Subdivision Name
SHAPIRO BUILDING - BWH BCMA PSYCHIATRY BWH BRIGHAM CIRCLE MEDICAL ASSOC. Psychiatry
Type
Rural Referral Center
Rural
Yes
340B ID
RRC220110-205
Medicare Provider Number
220110
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/15/2021
Last Recertification Date
Termination Date
Termination Reason
7/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Brigham and Women's Hospital - Boston, MA
Garrett McKinnon, Vice President of Finance
(857) 282-4406
Primary Contact
Brigham and Women’s Hospital
John Fanikos, Executive Director of Pharmacy Services
(617) 732-7165
Addresses
Street Address
70 Francis St
Boston, MA 02115
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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