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DOGWOOD PHARMACY LLC
DSH180012 Baptist Health Hardin
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Covered Entity Details
Entity Name
Baptist Health Hardin
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180012
Entity Address
913 NORTH DIXIE AVENUE
ELIZABETHTOWN, KY 42701
Medicare Provider Number
180012
Participating Start Date
4/1/2017
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
DOGWOOD PHARMACY LLC
Pharmacy Address
D/B/A MEDSCRIPTS MEDICAL PHARMACY
1325 MILLER RD
STE K
GREENVILLE, SC 29607-6541
Pharmacy Comments
Contract Details
Approval Date
4/6/2023
Contract Begin Date
4/10/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas Carrico, Chief Operating Officer
(270) 706-5321
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
4/6/2023
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