Contract Pharmacy Details

STONE SOUP ENTERPRISES, INC.
HM83712 ST LUKE'S REGIONAL MEDICAL CENTER, LTD

Covered Entity Details

Entity Name

ST LUKE'S REGIONAL MEDICAL CENTER, LTD

Subdivision Name

ST. LUKE'S HEMOPHILIA CENTER

Type

Comprehensive Hemophilia Treatment Center

340B ID

HM83712

Entity Address

100 E. IDAHO ST.
BOISE, ID 83712

Grant Number

H30MC240491300

Participating Start Date

1/1/2007

Last Recertification Date

2/25/2025

Pharmacy Details

Pharmacy Name

STONE SOUP ENTERPRISES, INC.

Pharmacy Address

18009 SKYPARK CIRCLE, STE G
IRVINE, CA 92614

Pharmacy Comments

Contract Details

Approval Date

2/8/2007

Contract Begin Date

2/8/2007

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/6/2015
Ownership change

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

1/29/2007

340B Drug Pricing Program Database