Contract Pharmacy Details

BLUE SKY SPECIALTY PHARMACY
RWIID90 SC DEPARTMENT OF PUBLIC HEALTH

Covered Entity Details

Entity Name

SC DEPARTMENT OF PUBLIC HEALTH

Subdivision Name

STD/HIV SECTION (SC ADAP Direct Purchase Operations)

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID90

Entity Address

2100 Bull Street
SC DPH, STD/HIV/VH Section (SC ADAP)
Columbia, SC 29201

Grant Number

X07HA00038

Participating Start Date

12/1/1992

Last Recertification Date

2/28/2025

Pharmacy Details

Pharmacy Name

BLUE SKY SPECIALTY PHARMACY

Pharmacy Address

BLUE SKY SPECIALTY PHARMACY
29640 STATE HIGHWAY 181 UNIT 106
DAPHNE, AL 36526

Pharmacy Comments

Contract Details

Approval Date

1/12/2024

Contract Begin Date

4/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Ali B Mansaray, Division Director of STD/HIV/AIDS/VH
(803) 898-0625

Contract Pharmacy Representative

Blue Sky Specialty Pharmacy
Juiana Horton-DeFrancis, VP of Managed Care Contracting and Payer Relations
(866) 822-0103

Signed By Date

1/12/2024

340B Drug Pricing Program Database