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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
DSH130007 Saint Alphonsus Regional Medical Center
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Covered Entity Details
Entity Name
Saint Alphonsus Regional Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH130007
Entity Address
1055 N. Curtis Rd.
Boise, ID 83706
Medicare Provider Number
130007
Participating Start Date
4/1/2012
Last Recertification Date
8/20/2024
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
7/11/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lannie Checketts, RHM CFO Idaho Oregon Region
(208) 367-7347
Contract Pharmacy Representative
Bioplus
Bill Cook, Executive VP of Sales
(866) 840-4067
Signed By Date
7/11/2024
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