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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
CAH051325-00 ADVENTIST HEALTH MENDOCINO COAST
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Covered Entity Details
Entity Name
ADVENTIST HEALTH MENDOCINO COAST
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH051325-00
Entity Address
700 RIVER DRIVE
FORT BRAGG, CA 95437
Medicare Provider Number
051325
Participating Start Date
8/11/2010
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
Pharmacy Address
376 NORTHLAKE BLVD
ALTAMONTE SPRINGS, FL 32701-5261
Pharmacy Comments
Contract Details
Approval Date
4/14/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Judson Howe, Network President
(707) 467-5352
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
4/14/2023
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