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CVS PHARMACY, INC.
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
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 02200
1030 PUTNAM AVENUE
MARSTONS MILLS, MA 02648
Pharmacy Comments
Contract Details
Approval Date
10/13/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Garrett McKinnon, Vice President of Finance
(857) 282-4406
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/13/2022
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