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BIOPLUS SPECIALTY PHARMACY, INC
CAH191302-00 ST. MARTIN HOSPITAL
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Covered Entity Details
Entity Name
ST. MARTIN HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH191302-00
Entity Address
210 CHAMPAGNE BLVD.
BREAUX BRIDGE, LA 70517
Medicare Provider Number
191302
Participating Start Date
9/28/2010
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
BIOPLUS SPECIALTY PHARMACY, INC
Pharmacy Address
3200 LAKE EMMA RD UNIT 1000
LAKE MARY, FL 32746
Pharmacy Comments
Contract Details
Approval Date
7/10/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/3/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Glenn Dailey, CEO
(337) 507-1201
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
7/10/2020
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