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BIOPLUS SPECIALTY INFUSION TX, LLC
DSH440152 Regional One Health
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Covered Entity Details
Entity Name
Regional One Health
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH440152
Entity Address
877 JEFFERSON AVENUE
MEMPHIS, TN 38103
Medicare Provider Number
440152
Participating Start Date
4/1/1993
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
BIOPLUS SPECIALTY INFUSION TX, LLC
Pharmacy Address
1748 N GREENVILLE AVE
RICHARDSON, TX 75081
Pharmacy Comments
Contract Details
Approval Date
10/10/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/24/2018
Agreement registered in error
Contacts
Covered Entity Signing Official
Rick Wagers, CFO
(901) 545-7676
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
10/10/2018
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