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CYSTIC FIBROSIS SERVICES, LLC
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
CYSTIC FIBROSIS SERVICES, LLC
Pharmacy Address
DBA WALGREENS SPECIALTY PHARMACY #16280
10530 JOHN W ELLIOTT DR STE 200
FRISCO, TX 75033
Pharmacy Comments
Contract Details
Approval Date
4/6/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DARLENE RODOWICZ, Executive Vice President & Treasurer
(413) 447-2809
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/6/2018
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