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EAST GOSHEN PHARMACY, LLC
DSH310014 THE COOPER HEALTH SYSTEM DBA COOPER UNIVERSITY HOSPITAL
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Covered Entity Details
Entity Name
THE COOPER HEALTH SYSTEM DBA COOPER UNIVERSITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH310014
Entity Address
ONE COOPER PLAZA
CAMDEN, NJ 08103
Medicare Provider Number
310014
Participating Start Date
1/1/2005
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
EAST GOSHEN PHARMACY, LLC
Pharmacy Address
DBA BIOSCRIP INFUSION SERVICES
970 RITTENHOUSE RD STE 200
AUDUBON, PA 19403
Pharmacy Comments
Contract Details
Approval Date
4/8/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brian M Reilly, CFO
(856) 342-2443
Contract Pharmacy Representative
Option Care Health
Jennifer Money, Manager, Health Systems Programs
(312) 940-2504
Signed By Date
4/8/2024
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