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BIOPLUS SPECIALTY INFUSION CA, LLC
DSH440039 Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic
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Covered Entity Details
Entity Name
Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH440039
Entity Address
1211 MEDICAL CENTER DRIVE
NASHVILLE, TN 37232
Medicare Provider Number
440039
Participating Start Date
7/1/2002
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
BIOPLUS SPECIALTY INFUSION CA, LLC
Pharmacy Address
19110 VAN NESS AVE.
TORRANCE, CA 90501
Pharmacy Comments
Contract Details
Approval Date
10/11/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/18/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Cecelia B Moore, Associate Vice Chancellor
(615) 322-0084
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
10/11/2018
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