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LYNNFIELD DRUG 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
LYNNFIELD DRUG INC
Pharmacy Address
DBA FREEDOM FERTILITY PHARMACY
374 MERRIMAC ST STE 100
NEWBURYPORT, MA 01950
Pharmacy Comments
Contract Details
Approval Date
4/17/2023
Contract Begin Date
5/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Garrett McKinnon, Vice President of Finance
(857) 282-4406
Contract Pharmacy Representative
Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/17/2023
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