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CVS PHARMACY, INC.
DSH220010 LAWRENCE GENERAL HOSPITAL
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Covered Entity Details
Entity Name
LAWRENCE GENERAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220010
Entity Address
1 GENERAL STREET
LAWRENCE, MA 01841
Medicare Provider Number
220010
Participating Start Date
7/1/2004
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 02596
150 LAFAYETTE SQUARE
HAVERHILL, MA 01832
Pharmacy Comments
Contract Details
Approval Date
1/11/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Turilli, Chief Financial Officer
(978) 946-8466
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/11/2022
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