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CVS PHARMACY, 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
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 00582
95 MAIN ST
SPENCER, MA 01562
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
THOMAS J. SULLIVAN, Vice President & CFO
(508) 765-8130
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/15/2019
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