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BIOSCRIP INFUSION SERVICES, LLC PHARMACY
DSH220163 UMASS MEMORIAL MEDICAL CENTER
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Covered Entity Details
Entity Name
UMASS MEMORIAL MEDICAL CENTER
Subdivision Name
UNIVERSITY CAMPUS
Type
Disproportionate Share Hospital
340B ID
DSH220163
Entity Address
55 LAKE AVENUE NORTH
WORCESTER, MA 01655
Medicare Provider Number
220163
Participating Start Date
10/1/2003
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
BIOSCRIP INFUSION SERVICES, LLC PHARMACY
Pharmacy Address
6 VREELAND RD STE 103
FLORHAM PARK, NJ 07932
Pharmacy Comments
Contract Details
Approval Date
7/9/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alice Shakman, Vice President Operations
(774) 443-0540
Contract Pharmacy Representative
Option Care
Derek Bilyk, Program Manager, Health Systems
(224) 813-1283
Signed By Date
7/9/2021
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