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THE OHIO STATE UNIVERSITY OUTPATIENT PHA
HM8395 The Ohio State University Hemostasis and Thrombosis Center at the James
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Covered Entity Details
Entity Name
The Ohio State University Hemostasis and Thrombosis Center at the James
Subdivision Name
HEMOPHILIA TREATMENT CENTER
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM8395
Entity Address
460 W. 10th Avenue
COLUMBUS, OH 43210
Grant Number
H30MC24047
Participating Start Date
1/1/2003
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
THE OHIO STATE UNIVERSITY OUTPATIENT PHA
Pharmacy Address
AT THE CCCT
460 W 10TH AVE RM L012
COLUMBUS, OH 43210
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eric H. Kraut, Director
(614) 293-2887
Contract Pharmacy Representative
Ohio State University
Kevin Wolowiec, Associate Director
(614) 685-4188
Signed By Date
10/15/2019
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