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OPTION CARE
DSH050039 ENLOE MEDICAL CENTER
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Covered Entity Details
Entity Name
ENLOE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050039
Entity Address
1531 ESPLANADE
CHICO, CA 95926
Medicare Provider Number
050039
Participating Start Date
1/1/2017
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
OPTION CARE
Pharmacy Address
OPTION CARE ENTERPRISES, INC.
132 MISSION RANCH BLVD.
CHICO, CA 95926-2186
Pharmacy Comments
Contract Details
Approval Date
10/11/2019
Contract Begin Date
10/15/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/9/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Kevin Woodward, VP/Chief Financial Officer
(530) 332-6733
Contract Pharmacy Representative
Option Care
Derek Bilyk, Program Manager, Health Systems
(224) 813-1283
Signed By Date
10/11/2019
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