340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-5278
DSH220077 BAYSTATE MEDICAL CENTER
Print
Covered Entity Details
Entity Name
BAYSTATE MEDICAL CENTER
Subdivision Name
BAYSTATE NORTH CAMPUS
Type
Disproportionate Share Hospital
340B ID
DSH220077
Entity Address
759 CHESTNUT STREET
SPRINGFIELD, MA 01199
Medicare Provider Number
220077
Participating Start Date
7/1/2003
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5278
Pharmacy Address
591 MEMORIAL DRIVE
CHICOPEE, MA 01020
Pharmacy Comments
Contract Details
Approval Date
8/30/2012
Contract Begin Date
9/1/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dennis Chalke, Sr. VP Finance & Community Hospitals/CFO & Treasurer
(413) 794-3290
Contract Pharmacy Representative
Wal-Mart
Marcus Osborne, V.P. Health & Wellness, Sales & Contracting
(479) 204-9374
Signed By Date
8/16/2012
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