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BIOPLUS SPECIALTY PHARMACY LA, LLC
DSH390270 GEISINGER WYOMING VALLEY MED CTR
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Covered Entity Details
Entity Name
GEISINGER WYOMING VALLEY MED CTR
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390270
Entity Address
1000 EAST MOUNTAIN BLVD
WILKES BARRE, PA 18711
Medicare Provider Number
390270
Participating Start Date
7/1/2017
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
BIOPLUS SPECIALTY PHARMACY LA, LLC
Pharmacy Address
2731 MANHATTAN BLVD STE B17
HARVEY, LA 70058
Pharmacy Comments
Contract Details
Approval Date
1/13/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/18/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ron Beer, Chief Admiistrative Officer
(570) 808-5380
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
1/13/2019
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