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CORAM ALTERNATE SITE SERVICES, INC.
DSH220035 NORTH SHORE MEDICAL CENTER
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Covered Entity Details
Entity Name
NORTH SHORE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220035
Entity Address
81 HIGHLAND AVENUE
SALEM, MA 01970
Medicare Provider Number
220035
Participating Start Date
9/5/2008
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
CORAM ALTERNATE SITE SERVICES, INC.
Pharmacy Address
DBA CORAM CVS/SPECIALTY INFUSION SERVICE
2345 WATERS DRIVE
MENDOTA HEIGHTS, MN 55120
Pharmacy Comments
Contract Details
Approval Date
1/14/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Charles E Adams, Executive Director, Finance
(978) 354-4000
Contract Pharmacy Representative
Massachusetts General Hospital
Rafic Nehme, Director, Pharmacy Business & Finance
(617) 726-5125
Signed By Date
1/14/2025
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