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RRC220110-204 BRIGHAM AND WOMENS HOSPITAL (Active)
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Main Details
Name
BRIGHAM AND WOMENS HOSPITAL
Subdivision Name
BRIGHAM AND WOMEN'S HEALTH CARE CENTER - BWH REHAB OT HAND 850 BWH REHAB SERVICES @ 850 BOYLSTON Occupational Therapy
Type
Rural Referral Center
Rural
Yes
340B ID
RRC220110-204
Medicare Provider Number
220110
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2021
Participating Start Date
1/1/2022
Participating Approval Date
11/15/2021
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Brigham and Women's Hospital - Boston, MA
Garrett McKinnon, Vice President of Finance
(857) 282-4406
Primary Contact
Massachusetts General Hospital
Rafic Nehme, Director, Pharmacy Business & Finance
(617) 726-5125
Addresses
Street Address
850 Boylston St
Chestnut Hill, MA 02467
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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In order for OPA to review/approve registrations-the following actions must first take place; a) Since the AO is no longer working at the CE, a NEW AO needs to be identified (ASAP) and change request submitted for the parent record: RRC220110-00, b) secondly the S2 states line 21 shows control type as: "4"-entities should be voluntary non-profit -other as proposed by user-please explain why the entity checked "4" on the MCR S2, please clarify/explain and submit documentation from IRS/CMS indicating non-profit status****NOTE****Please clarify/explain and upload/attach State IRS/CMS letter confirming non-profit status within 5 days (11/09/21) to avoid all registration(s) from being rejected
11/05/2021
April 2025
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