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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
DSH050239 GLENDALE ADVENTIST MEDICAL CENTER
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Covered Entity Details
Entity Name
GLENDALE ADVENTIST MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050239
Entity Address
1509 WILSON TERRACE
GLENDALE, CA 91206
Medicare Provider Number
050239
Participating Start Date
4/1/2005
Last Recertification Date
8/29/2024
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
7/12/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alice Issai, President
(818) 409-8301
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
7/12/2024
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