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ACRO PHARMACEUTICAL SERVICES LLC
DSH450723 METHODIST CHARLTON MEDICAL CENTER
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Covered Entity Details
Entity Name
METHODIST CHARLTON MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450723
Entity Address
3500 WEST WHEATLAND ROAD
DALLAS, TX 75237-3460
Medicare Provider Number
450723
Participating Start Date
7/1/2005
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
ACRO PHARMACEUTICAL SERVICES LLC
Pharmacy Address
ACRO PHARMACEUTICAL SERVICES LLC
313 HENDERSON DR
SHARON HILL, PA 19079
Pharmacy Comments
Contract Details
Approval Date
7/14/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/7/2019
Ownership change
Contacts
Covered Entity Signing Official
FRANCES LAUKAITIS, PRESIDENT
(214) 947-7707
Contract Pharmacy Representative
Commcare Pharmacy
Avani Patel, Client Relations Manager
(954) 284-2358
Signed By Date
7/14/2017
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