Contract Pharmacy Details

D.A.W., LLC
DSH220011 CAMBRIDGE PUBLIC HEALTH COMMISSION

Covered Entity Details

Entity Name

CAMBRIDGE PUBLIC HEALTH COMMISSION

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH220011

Entity Address

1493 Cambridge Street
CAMBRIDGE, MA 02139

Medicare Provider Number

220011

Participating Start Date

7/1/1998

Last Recertification Date

8/30/2024

Pharmacy Details

Pharmacy Name

D.A.W., LLC

Pharmacy Address

D/B/A CVS/PHARMACY # 11265
270 UNION STREET
LYNN, MA 01901

Pharmacy Comments

Contract Details

Approval Date

7/2/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/27/2023
Pharmacy closed

Contacts

Covered Entity Signing Official

Andrew M Fuqua, Senior Vice President and General Counsel
(617) 665-1000

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

7/2/2020

340B Drug Pricing Program Database