Contract Pharmacy Details

DOGWOOD PHARMACY LLC
DSH390115 Jefferson Health Northeast

Covered Entity Details

Entity Name

Jefferson Health Northeast

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH390115

Entity Address

10800 Knights Rd.
PHILADELPHIA, PA 19114

Medicare Provider Number

390115

Participating Start Date

10/1/2017

Last Recertification Date

8/19/2024

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

1/11/2024

Contract Begin Date

4/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

CARRIE FREY, Director of Finance
(215) 612-4313

Contract Pharmacy Representative

BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209

Signed By Date

1/11/2024

340B Drug Pricing Program Database