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OPTION CARE ENTERPRISES, 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
OPTION CARE ENTERPRISES, INC.
Pharmacy Address
OPTION CARE
870 N. ARLINGTON HEIGHTS RD
SUITE 101
ITASCA, IL 60143
Pharmacy Comments
Contract Details
Approval Date
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristine Hanscom, CFO
(617) 636-7767
Contract Pharmacy Representative
Option Care
Jenny Money, Senior Manager, Health Systems Programs
(773) 202-6786
Signed By Date
7/14/2021
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