Contract Pharmacy Details

BOSTON MEDICAL CENTER PHARMACY AT SHAPIR
DSH220024 HOLYOKE MEDICAL CENTER

Covered Entity Details

Entity Name

HOLYOKE MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH220024

Entity Address

575 BEECH STREET
HOLYOKE, MA 01040

Medicare Provider Number

220024

Participating Start Date

10/1/2004

Last Recertification Date

8/20/2024

Pharmacy Details

Pharmacy Name

BOSTON MEDICAL CENTER PHARMACY AT SHAPIR

Pharmacy Address

725 ALBANY ST
PHARMACY
BOSTON, MA 02118-2526

Pharmacy Comments

Contract Details

Approval Date

1/9/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/31/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

SPIROS HATIRAS, CEO
(413) 534-2667

Contract Pharmacy Representative

Boston Medical Center
Noreen A. Palinkas, Director Pharmacy Compliance
(617) 638-5843

Signed By Date

1/9/2020

340B Drug Pricing Program Database