340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BIOSCRIP INFUSION SERVICES, INC.
DSH050696 Keck Hospital of USC
Print
Covered Entity Details
Entity Name
Keck Hospital of USC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050696
Entity Address
1500 SAN PABLO STREET
LOS ANGELES, CA 90033
Medicare Provider Number
050696
Participating Start Date
4/1/2010
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
BIOSCRIP INFUSION SERVICES, INC.
Pharmacy Address
320 S FLOWER ST
BURBANK, CA 91502-2103
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
10/15/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/20/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Rod Hanners, Chief Operating Officer
(323) 442-8677
Contract Pharmacy Representative
Option Care
Derek Bilyk, Program Manager, Health Systems
(224) 813-1283
Signed By Date
10/14/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session