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ACRO PHARMACEUTICAL SERVICES LLC
DSH360161 ST. JOSEPH WARREN HOSPITAL
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Covered Entity Details
Entity Name
ST. JOSEPH WARREN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360161
Entity Address
667 EASTLAND AVENUE SE
WARREN, OH 44484
Medicare Provider Number
360161
Participating Start Date
7/1/2018
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
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/22/2019
Ownership change
Contacts
Covered Entity Signing Official
Anthony Seminaro, CFO, Markets
(941) 587-1220
Contract Pharmacy Representative
Commcare Specialty Pharmacy
Bob Raffalo, VP Operations
(954) 284-2384
Signed By Date
1/15/2019
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