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RIVER MEDICAL PHARMACY LLC
CAN050660-00 USC Norris Cancer Hospital
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Covered Entity Details
Entity Name
USC Norris Cancer Hospital
Subdivision Name
Type
Free Standing Cancer Hospital
340B ID
CAN050660-00
Entity Address
1441 Eastlake Avenue
Los Angeles, CA 90033
Medicare Provider Number
050660
Participating Start Date
1/1/2014
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
RIVER MEDICAL PHARMACY LLC
Pharmacy Address
4752 RESEARCH DR
SAN ANTONIO, TX 78240-5002
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rod Hanners, Chief Operating Officer
(323) 442-8677
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
7/17/2023
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