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DSH220095Q HENRY HEYWOOD MEMORIAL HOSPITAL (Active)
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Main Details
Name
HENRY HEYWOOD MEMORIAL HOSPITAL
Subdivision Name
HEYWOOD ENDOCRINOLOGY - Endocrinology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH220095Q
Medicare Provider Number
220095
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2025
Participating Start Date
4/1/2025
Participating Approval Date
2/12/2025
Last Recertification Date
Contacts
Authorizing Official
Heywood Healthcare
John Bujak, Chief Financial Officer
(978) 630-6202
Primary Contact
Heywood Healthcare
Lori Doucette, 340B Program Director
(978) 630-6161 Ext: 2076298672
Addresses
Street Address
250 GREEN ST
STE 104
GARDNER, MA 01440-1377
Billing Address
Henry Heywood Memorial Hospital
242 Green Street
Gardner, MA 01440
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2023, terminated 4/1/2024. Reinstated 4/1/2025.
02/12/2025
May 2025
May 2025
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