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BROWN UNIVERSITY HEALTH PHARMACY NO 003
DSH220020 STEWARD ST. ANNES HOSPITAL
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Covered Entity Details
Entity Name
STEWARD ST. ANNES HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220020
Entity Address
795 MIDDLE STREET
FALL RIVER, MA 02721
Medicare Provider Number
220020
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
BROWN UNIVERSITY HEALTH PHARMACY NO 003
Pharmacy Address
180 CORLISS ST STE A
PROVIDENCE, RI 02904
Pharmacy Comments
Contract Details
Approval Date
2/4/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jason Levine, VP Finance
(508) 674-5600 Ext: 2007
Contract Pharmacy Representative
Brown University Health
Christine Collins, SVP, Pharmacy Periop Chief Pharmacy Officer
(401) 444-4434
Signed By Date
1/15/2025
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