340B Drug Pricing Program Database
COMMCARE PHARMACY-FTL, LLC
DSH180138B Baptist Health Lagrange - information as of 6/14/2025 10:27:24 AM
Covered Entity Details
Entity Name
Baptist Health Lagrange
Subdivision Name
BAPTIST HEALTH LAGRANGE EASTPOINT ONCOLOGY INFUSION
Type
Disproportionate Share Hospital
340B ID
DSH180138B
Entity Address
2400 EASTPOINT PARKWAY STE 310
LOUISVILLE, KY 40223
Medicare Provider Number
180138
Outpatient Facility Provider Number
Participating Start Date
1/1/2016
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
COMMCARE PHARMACY-FTL, LLC
Pharmacy Address
855 SW 78TH AVE STE C100
PLANTATION, FL 33324-3223
Pharmacy Comments
Contract Details
Approval Date
1/11/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/19/2019
Ownership change
Contacts
Covered Entity Signing Official
Christopher M. Roty, President
(859) 260-6104
Contract Pharmacy Representative
Commcare Pharmacy
Avani Patel, Client Relations Manager
(561) 310-4324
Signed By Date
1/11/2016
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