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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
DSH240019 SMDC MEDICAL CENTER
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Covered Entity Details
Entity Name
SMDC MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH240019
Entity Address
502 E 2ND ST
DULUTH, MN 55805
Medicare Provider Number
240019
Participating Start Date
9/3/2008
Last Recertification Date
8/19/2024
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
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bradley Beard, Chief Operating Officer
(218) 786-2652
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
7/15/2024
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