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CORAM ALTERNATE SITE SERVICES, INC.
DSH220116 TUFTS MEDICAL CENTER
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Covered Entity Details
Entity Name
TUFTS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220116
Entity Address
800 WASHINGTON STREET
BOSTON, MA 02111
Medicare Provider Number
220116
Participating Start Date
10/1/2003
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
CORAM ALTERNATE SITE SERVICES, INC.
Pharmacy Address
DBA CORAM CVS/SPECIALTY INFUSION SERVICE
6 SPRING MILL DR
MALVERN, PA 19355
Pharmacy Comments
Contract Details
Approval Date
1/13/2021
Contract Begin Date
2/10/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristine Hanscom, CFO
(617) 636-7767
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/13/2021
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