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RIVER MEDICAL PHARMACY LLC
DSH050496 JOHN MUIR MEDICAL CENTER - CONCORD
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Covered Entity Details
Entity Name
JOHN MUIR MEDICAL CENTER - CONCORD
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050496
Entity Address
2540 EAST STREET
CONCORD, CA 94520
Medicare Provider Number
050496
Participating Start Date
1/1/2023
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
RIVER MEDICAL PHARMACY LLC
Pharmacy Address
4752 RESEARCH DR
SAN ANTONIO, TX 78240-5002
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
Zach Harris, VP Ancillary Services
(808) 457-0157
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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