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BERKSHIRE COMMUNITY PHARMACY OF NORTH AD
CAH221302-00 FAIRVIEW HOSPITAL
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Covered Entity Details
Entity Name
FAIRVIEW HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH221302-00
Entity Address
29 LEWIS AVE
GREAT BARRINGTON, MA 01230
Medicare Provider Number
221302
Participating Start Date
9/27/2010
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
BERKSHIRE COMMUNITY PHARMACY OF NORTH AD
Pharmacy Address
71 HOSPITAL AVENUE
NORTH ADAMS, MA 01247
Pharmacy Comments
Contract Details
Approval Date
10/1/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DARLENE RODOWICZ, Executive Vice President & Treasurer
(413) 447-2809
Contract Pharmacy Representative
Berkshire Health Systems
David MacHaffie, Pharmacy Director
(413) 395-7912
Signed By Date
10/1/2019
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