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SANTA BARBARA SPECIALTY PHARMACY LLC
CAH151304-00 RUSH MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
RUSH MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH151304-00
Entity Address
1300 N. MAIN STREET
RUSHVILLE, IN 46173
Medicare Provider Number
151304
Participating Start Date
8/30/2010
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
SANTA BARBARA SPECIALTY PHARMACY LLC
Pharmacy Address
4690 CARPINTERIA AVE STE B
CARPINTERIA, CA 93013
Pharmacy Comments
Contract Details
Approval Date
4/5/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BRADLEY SMITH, CEO
(765) 932-7513
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
4/5/2024
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