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ACRO PHARMACEUTICAL SERVICES LLC
DSH360276 ST ELIZABETH BOARDMAN HEALTH CTR
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Covered Entity Details
Entity Name
ST ELIZABETH BOARDMAN HEALTH CTR
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360276
Entity Address
8401 MARKET STREET
Boardman, OH 44512
Medicare Provider Number
360276
Participating Start Date
10/1/2017
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
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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