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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
SCH360125-00 Ashtabula County Medical Center
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Covered Entity Details
Entity Name
Ashtabula County Medical Center
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH360125-00
Entity Address
2420 Lake Avenue
Ashtabula, OH 44004
Medicare Provider Number
360125
Participating Start Date
1/1/2012
Last Recertification Date
9/9/2024
Entity Termination Date
7/1/2025
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
7/10/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Alanna Dames, Chief Financial Officer
(440) 997-6553
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
7/10/2024
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