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BAPTIST HEALTH PHARMACY #101, LLC
DSH100008 Baptist Hospital of Miami, INC
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Covered Entity Details
Entity Name
Baptist Hospital of Miami, INC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH100008
Entity Address
8900 North Kendall Drive
MIAMI, FL 33176
Medicare Provider Number
100008
Participating Start Date
9/9/2005
Last Recertification Date
8/28/2024
Pharmacy Details
Pharmacy Name
BAPTIST HEALTH PHARMACY #101, LLC
Pharmacy Address
8950 N KENDALL DR STE 102
MIAMI, FL 33176-2131
Pharmacy Comments
Contract Details
Approval Date
4/14/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/28/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Madeline Camejo, Vice President and Chief Pharmacy Officer
(786) 662-0801
Contract Pharmacy Representative
Baptist Health Medical Group, Inc
Gordon Garland, Director, Retail Pharmacy
(786) 662-0828
Signed By Date
4/14/2021
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