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WALGREEN EASTERN CO., INC.
DSH220019 UMass Memorial Health - Harrington Hospital, Inc.
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Covered Entity Details
Entity Name
UMass Memorial Health - Harrington Hospital, Inc.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220019
Entity Address
100 SOUTH STREET
SOUTHBRIDGE, MA 01550
Medicare Provider Number
220019
Participating Start Date
7/1/2009
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WALGREEN EASTERN CO., INC.
Pharmacy Address
WALGREENS #19747
175 MAIN ST
OXFORD, MA 01540
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/2/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
THOMAS J. SULLIVAN, Vice President & CFO
(508) 765-8130
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/15/2018
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