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ACRO PHARMACEUTICAL SERVICES LLC
DSH360025 FIRELANDS REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
FIRELANDS REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360025
Entity Address
1111 HAYES AVENUE
SANDUSKY, OH 44870
Medicare Provider Number
360025
Participating Start Date
1/1/2017
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
ACRO PHARMACEUTICAL SERVICES LLC
Pharmacy Address
ACRO PHARMACEUTICAL SERVICES LLC
313 HENDERSON DR
SHARON HILL, PA 19079
Pharmacy Comments
Contract Details
Approval Date
10/1/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/31/2019
Pharmacy closed
Contacts
Covered Entity Signing Official
Daniel J. Moncher, Executive Vice President & CFO
(419) 557-7793
Contract Pharmacy Representative
Commcare Specialty Pharmacy
Bob Raffalo, VP Operations
(954) 284-2384
Signed By Date
10/1/2018
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