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CVS PHARMACY, INC.
DSH220031 BOSTON MEDICAL CENTER
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Covered Entity Details
Entity Name
BOSTON MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220031
Entity Address
1 Boston Medical Center Place
BOSTON, MA 02118
Medicare Provider Number
220031
Participating Start Date
12/1/1992
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 03307
400 TREMONT STREET
BOSTON, MA 02116
Pharmacy Comments
Contract Details
Approval Date
4/21/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/18/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Kathleen E. Walsh, Chief Executive Officer
(617) 638-6911
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/21/2022
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