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CVS PHARMACY, INC.
RRC220071-00 MASSACHUSETTS GENERAL HOSPITAL
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Covered Entity Details
Entity Name
MASSACHUSETTS GENERAL HOSPITAL
Subdivision Name
The General Hospital Corporation
Type
Rural Referral Center
340B ID
RRC220071-00
Entity Address
55 FRUIT STREET
BOSTON, MA 02114
Medicare Provider Number
220071
Participating Start Date
1/1/2020
Last Recertification Date
9/7/2020
Entity Termination Date
3/24/2021
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 00717
36 WHITE STREET
CAMBRIDGE, MA 02140
Pharmacy Comments
Contract Details
Approval Date
11/7/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/24/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
O'Neil Britton, M.D., Chief Medical Officer, Senior Vice President Administration
(617) 724-1276
Contract Pharmacy Representative
Wellpartner
Jessica Thomas, Senior Account Manager
(212) 419-4046
Signed By Date
10/15/2019
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