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TRINITY HEALTH PHARMACY SERVICES, LLC
DSH080003 ST FRANCIS HOSPITAL, INC
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Covered Entity Details
Entity Name
ST FRANCIS HOSPITAL, INC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH080003
Entity Address
701 NORTH CLAYTON STREET
WILMINGTON, DE 19805-0500
Medicare Provider Number
080003
Participating Start Date
10/1/2009
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
TRINITY HEALTH PHARMACY SERVICES, LLC
Pharmacy Address
12279 BLUFFTON RD
FORT WAYNE, IN 46809-3208
Pharmacy Comments
Contract Details
Approval Date
7/6/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephanie Templeton, Director of Financial Operations
(302) 575-8365
Contract Pharmacy Representative
TRINITY HEALTH
ZACHARY ROBERTS, DIRECTOR OF SPECIALTY PHARMACY
(734) 343-7606
Signed By Date
7/6/2021
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