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BIOPLUS SPECIALTY PHARMACY LA, LLC
DSH450102 CHRISTUS MOTHER FRANCES HOSP-TYLER
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Covered Entity Details
Entity Name
CHRISTUS MOTHER FRANCES HOSP-TYLER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450102
Entity Address
800 EAST DAWSON
TYLER, TX 75701
Medicare Provider Number
450102
Participating Start Date
3/10/2022
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
BIOPLUS SPECIALTY PHARMACY LA, LLC
Pharmacy Address
2731 MANHATTAN BLVD STE B17
HARVEY, LA 70058
Pharmacy Comments
Contract Details
Approval Date
1/16/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Elizabeth Pulliam, Chief Financial Officer
(903) 606-4102
Contract Pharmacy Representative
The Kroger Co
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
1/16/2023
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