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NORTH SHORE PHARMACY SERVICES
CHC29010-02 UPHAMS CORNER HEALTH COMMITTEE, INC.
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Covered Entity Details
Entity Name
UPHAMS CORNER HEALTH COMMITTEE, INC.
Subdivision Name
Upham's Corner Health Center - Business & Human Resources Office
Type
HRSA-Funded Health Center
340B ID
CHC29010-02
Entity Address
500 Columbia Rd
Dorchester, MA 02125-2322
Grant Number
H80CS29010
Participating Start Date
1/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
NORTH SHORE PHARMACY SERVICES
Pharmacy Address
OMNICARE OF NORTHERN MASSACHUSETTS
2 TECHNOLOGY DRIVE
PEABODY, MA 01960
Pharmacy Comments
Contract Details
Approval Date
4/13/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/31/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jagdeep Trivedi, CEO
(617) 287-8000 Ext: 8131
Contract Pharmacy Representative
Eaton Apothecary
John H. Lynch, General Manager
(401) 665-9677
Signed By Date
4/13/2018
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