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NEW ENGLAND LIFE CARE
RRC220110-00 BRIGHAM AND WOMENS HOSPITAL
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Covered Entity Details
Entity Name
BRIGHAM AND WOMENS HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC220110-00
Entity Address
75 FRANCIS STREET
BOSTON, MA 02115
Medicare Provider Number
220110
Participating Start Date
1/1/2019
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
NEW ENGLAND LIFE CARE
Pharmacy Address
780 DEDHAM ST STE 300
CANTON, MA 02021
Pharmacy Comments
Contract Details
Approval Date
7/9/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/18/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Christopher Dunleavy, Chief Financial Officer
(617) 732-7899
Contract Pharmacy Representative
New England Life Care Inc.
Michael Gallagher, Chief Financial Officer
(781) 932-4347
Signed By Date
7/9/2021
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