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OPTION CARE ENTERPRISES, INC.
DSH070028 ST. VINCENTS MEDICAL CENTER
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Covered Entity Details
Entity Name
ST. VINCENTS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH070028
Entity Address
2800 MAIN STREET
BRIDGEPORT, CT 06606-4201
Medicare Provider Number
070028
Participating Start Date
1/13/2023
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
OPTION CARE ENTERPRISES, INC.
Pharmacy Address
OPTION CARE
870 N. ARLINGTON HEIGHTS RD
SUITE 101
ITASCA, IL 60143
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
1/13/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher Given, VP, Finance
(475) 210-6193
Contract Pharmacy Representative
Option Care Health
Jennifer Money, Manager, Health Systems Programs
(312) 940-2504
Signed By Date
1/8/2023
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