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IVY HOME INFUSIONS LLC
HM995081 Alaska Bleeding Disorder Clinics
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Covered Entity Details
Entity Name
Alaska Bleeding Disorder Clinics
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM995081
Entity Address
1200 Airport Heights Dr.
101
Anchorage, AK 99508
Grant Number
H30MC24049
Participating Start Date
1/1/2020
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
IVY HOME INFUSIONS LLC
Pharmacy Address
1200 AIRPORT HEIGHTS DR STE E-195
ANCHORAGE, AK 99508
Pharmacy Comments
Contract Details
Approval Date
10/31/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Palmatier, Board President
(907) 929-2568
Contract Pharmacy Representative
Alaska Bleeding Disorder Clinics
John Palmatier, Board President
(907) 929-2568
Signed By Date
10/14/2019
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