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RED CHIP OF NEVADA
HM02146 BRIGHAM & WOMEN'S PHYSICIANS ORGANIZATION (BWPO)
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Covered Entity Details
Entity Name
BRIGHAM & WOMEN'S PHYSICIANS ORGANIZATION (BWPO)
Subdivision Name
BOSTON BLEEDING DISORDERS CENTER
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM02146
Entity Address
1620 Tremont Street
BOSTON, MA 02120-1613
Grant Number
5 H30 MC24048
Participating Start Date
1/1/1998
Last Recertification Date
3/10/2025
Pharmacy Details
Pharmacy Name
RED CHIP OF NEVADA
Pharmacy Address
18009 SKY PARK CIRCLE SUITE F
IRVINE, CA 92614-9261
Pharmacy Comments
Contract Details
Approval Date
1/10/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin T. Giordano, Executive Administrator
(617) 525-9444
Contract Pharmacy Representative
Red Chip Of Nevada
Vishal Gandhi, Pharmacy Manager
(949) 223-9830
Signed By Date
1/10/2019
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