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LYNNFIELD DRUG 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
LYNNFIELD DRUG INC
Pharmacy Address
DBA FREEDOM FERTILITY PHARMACY
374 MERRIMAC ST STE 100
NEWBURYPORT, MA 01950
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kathleen E. Walsh, Chief Executive Officer
(617) 638-6911
Contract Pharmacy Representative
Lynfield Drug, Inc.
Hilary Thibault, Pharmacist in Charge
(800) 660-4283 Ext: 271916
Signed By Date
10/16/2017
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