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CAPE COD HEALTHCARE PHARMACY AT CCH
HV02601 CAPE COD HOSPITAL
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Covered Entity Details
Entity Name
CAPE COD HOSPITAL
Subdivision Name
RYAN WHITE PART C OUTPATIENT EIS PROGRAM
Type
Ryan White Part C
340B ID
HV02601
Entity Address
34 PARK STREET
Hyannis, MA 02601-5230
Grant Number
H76HA00764
Participating Start Date
1/1/2020
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
CAPE COD HEALTHCARE PHARMACY AT CCH
Pharmacy Address
27 PARK ST
HYANNIS, MA 02601-5230
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
michael connors, CFO
(774) 470-5569
Contract Pharmacy Representative
Cape Cod Healthcare
Angela M Medeiros, Pharmacy Director
(508) 862-5903
Signed By Date
1/13/2020
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