Contract Pharmacy Details

WILLIAMSTOWN APOTHECARY
CAH221302-00 FAIRVIEW HOSPITAL

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

WILLIAMSTOWN APOTHECARY

Pharmacy Address

BERKSHIRE HEALTH SYSTEMS
72 SPRING ST.
WILLIAMSTOWN, MA 01267

Pharmacy Comments

Contract Details

Approval Date

6/18/2020

Contract Begin Date

6/18/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/14/2024
Pharmacy closed

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

6/18/2020

340B Drug Pricing Program Database