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IVIRA PHARMACY
DSH080003 ST FRANCIS HOSPITAL, INC
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Covered Entity Details
Entity Name
ST FRANCIS HOSPITAL, INC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH080003
Entity Address
701 NORTH CLAYTON STREET
WILMINGTON, DE 19805-0500
Medicare Provider Number
080003
Participating Start Date
10/1/2009
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
IVIRA PHARMACY
Pharmacy Address
824 N MARKET ST
STE 103
WILMINGTON, DE 19801
Pharmacy Comments
Contract Details
Approval Date
4/9/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/15/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Dale Szafran, Director of Financial Operations
(302) 421-4665
Contract Pharmacy Representative
GreenHill Pharmacy
Jay C patel, Founder and President
(302) 660-8847
Signed By Date
4/9/2019
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