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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
SCH460019-00 Uintah Basin Medical Center
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Covered Entity Details
Entity Name
Uintah Basin Medical Center
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH460019-00
Entity Address
250 West 300 North
Roosevelt, UT 84066
Medicare Provider Number
460019
Participating Start Date
7/1/2012
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
Pharmacy Address
BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
145 S 79TH ST STE 70
CHANDLER, AZ 85226
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brent Hales, CFO
(435) 722-6164
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
4/15/2024
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