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ACRO PHARMACEUTICAL SERVICES, LLC
DSH100088 BAPTIST MEDICAL CENTER
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Covered Entity Details
Entity Name
BAPTIST MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH100088
Entity Address
800 PRUDENTIAL DRIVE
JACKSONVILLE, FL 32207
Medicare Provider Number
100088
Participating Start Date
7/1/2006
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
ACRO PHARMACEUTICAL SERVICES, LLC
Pharmacy Address
7891 STAGE HILLS BLVD STE 111
BARTLETT, TN 38133
Pharmacy Comments
Contract Details
Approval Date
4/17/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Scott M. Wooten, SVP & CFO
(904) 202-3405
Contract Pharmacy Representative
Commcare Pharmacy
Avani Patel, Client Relations Manager
(954) 284-2358
Signed By Date
4/17/2017
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