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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
DSH180138 Baptist Health Lagrange
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Covered Entity Details
Entity Name
Baptist Health Lagrange
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180138
Entity Address
1025 New Moody Lane
La Grange, KY 40031
Medicare Provider Number
180138
Participating Start Date
7/1/2013
Last Recertification Date
8/14/2024
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
7/2/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Clint Kaho, President
(502) 222-3329
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
7/2/2024
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