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ADVANCED CARE SCRIPTS, INC
CAH131325-00 BMH, INC. DBA BINGHAM MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
BMH, INC. DBA BINGHAM MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH131325-00
Entity Address
98 POPLAR
BLACKFOOT, ID 83221
Medicare Provider Number
131325
Participating Start Date
9/8/2010
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
ADVANCED CARE SCRIPTS, INC
Pharmacy Address
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
6251 CHANCELLOR DRIVE
SUITE 101
ORLANDO, FL 32809
Pharmacy Comments
Contract Details
Approval Date
1/19/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jake Erickson, CEO
(208) 785-3803
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/19/2023
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