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T C FLYNN PHARMACY
DSH220046 BERKSHIRE MEDICAL CENTER
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Covered Entity Details
Entity Name
BERKSHIRE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220046
Entity Address
725 NORTH STREET
PITTSFIELD, MA 01201
Medicare Provider Number
220046
Participating Start Date
1/1/2010
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
T C FLYNN PHARMACY
Pharmacy Address
173 ELM ST
PITTSFIELD, MA 01201
Pharmacy Comments
Contract Details
Approval Date
11/20/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DARLENE RODOWICZ, Executive Vice President & Treasurer
(413) 447-2809
Contract Pharmacy Representative
T C Flynn Pharmacy
CHRIS FLYNN, Owner
(413) 445-5567
Signed By Date
10/3/2012
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