340B Drug Pricing Program Database
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CVS PHARMACY, INC.
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
CVS PHARMACY, INC.
Pharmacy Address
DBA: CVS/PHARMACY # 00471
778 DUDLEY ST.
DORCHESTER, MA 02125
Pharmacy Comments
Contract Details
Approval Date
7/24/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathleen E. Walsh, Chief Executive Officer
(617) 638-6911
Contract Pharmacy Representative
CVS Caremark
Anthony Gratto, 340B Vendor Manager
(401) 770-7298
Signed By Date
7/24/2013
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