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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
DSH490037 RIVERSIDE SHORE MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
RIVERSIDE SHORE MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH490037
Entity Address
20480 Market Street
Onancock, VA 23417
Medicare Provider Number
490037
Participating Start Date
7/1/2004
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
7/16/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
WILLIAM W. AUSTIN JR., SENIOR VP & CFO
(757) 534-7015
Contract Pharmacy Representative
Bioplus
Bill Cook, Executive VP of Sales
(866) 840-4067
Signed By Date
7/16/2024
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