340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
UMASS MEMORIAL MEDICAL CENTER, INC.
DSH220074 SOUTHCOAST HOSPITALS GROUP, INC
Print
Covered Entity Details
Entity Name
SOUTHCOAST HOSPITALS GROUP, INC
Subdivision Name
DBA CHARLTON MEMORIAL HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH220074
Entity Address
363 HIGHLAND AVENUE
FALL RIVER, MA 02720
Medicare Provider Number
220074
Participating Start Date
7/1/2004
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
UMASS MEMORIAL MEDICAL CENTER, INC.
Pharmacy Address
UMASS MEMORIAL MEDICAL CENTER SPECIALTY
55 LAKE AVE N
ACC BUILDING - 1ST FLOOR - SUITE AC1.033
WORCESTER, MA 01655-0002
Pharmacy Comments
Contract Details
Approval Date
10/17/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/9/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Renee Clark, Exec. Vice President & Chief Operating Officer
(508) 973-5872
Contract Pharmacy Representative
UMass Memorial Medical Center
Alice Shakman, Vice President Operations
(774) 443-0540
Signed By Date
10/17/2017
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