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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
DSH450101 HILLCREST BAPTIST MEDICAL CENTER
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Covered Entity Details
Entity Name
HILLCREST BAPTIST MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH450101
Entity Address
100 HILLCREST MEDICAL BLVD
WACO, TX 76712
Medicare Provider Number
450101
Participating Start Date
7/1/2005
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
7/10/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shellie Mach, CFO
(254) 202-9414
Contract Pharmacy Representative
Bioplus Specialty Pharmacies
Bill Cook, SVP Business Development
(407) 830-8820 Ext: 4210
Signed By Date
7/10/2024
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