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EAST BOSTON NEIGHBORHOOD HEALTH CENTER
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
EAST BOSTON NEIGHBORHOOD HEALTH CENTER
Pharmacy Address
MAVERICK PHARMACY
20 MAVERICK SQ
EAST BOSTON, MA 02128-2335
Pharmacy Comments
Contract Details
Approval Date
10/18/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathleen E. Walsh, Chief Executive Officer
(617) 638-6911
Contract Pharmacy Representative
East Boston Neighborhood Health Center
Ernani DeAraujo, Vice President & General Counsel
(617) 568-4567
Signed By Date
10/18/2022
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