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BRIGHAM AND WOMEN'S HOSPITAL
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
BRIGHAM AND WOMEN'S HOSPITAL
Pharmacy Address
OUTPATIENT PHARMACY
45 FRANCIS ST
BOSTON, MA 02115-6105
Pharmacy Comments
Contract Details
Approval Date
1/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Garrett McKinnon, Vice President of Finance
(857) 282-4406
Contract Pharmacy Representative
Brigham and Women's Hospital - Boston, MA
Garrett McKinnon, Vice President of Finance
(857) 282-4406
Signed By Date
1/12/2024
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