340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BRIOVARX OF MASSACHUSETTS, LLC
DSH010092 DCH REGIONAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
DCH REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH010092
Entity Address
809 UNIVERSITY BOULEVARD EAST
TUSCALOOSA, AL 35401
Medicare Provider Number
010092
Participating Start Date
1/1/2004
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
BRIOVARX OF MASSACHUSETTS, LLC
Pharmacy Address
D/B/A BRIOVARX
BLDG 2 - UNIT A
145 BODWELL STREET
AVON, MA 02322
Pharmacy Comments
Contract Details
Approval Date
7/17/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/13/2020
Ownership change
Contacts
Covered Entity Signing Official
NINA DUSANG, CFO
(205) 759-7738
Contract Pharmacy Representative
Optum
NATHAN WHITE, Vice President Sales - TPA & Hospital
(813) 949-1951
Signed By Date
7/17/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session