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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
DSH370093 OU MEDICAL CENTER
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Covered Entity Details
Entity Name
OU MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH370093
Entity Address
700 NE 13TH ST.
OKLAHOMA CITY, OK 73104
Medicare Provider Number
370093
Participating Start Date
7/1/2018
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
Pharmacy Address
BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
4740 VICTORY LN STE C
INDIANAPOLIS, IN 46203
Pharmacy Comments
Contract Details
Approval Date
7/17/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Krystal L Murer, Vice President | Ethics, Regulatory Affairs, and Chief Compliance Officer
(405) 271-8052
Contract Pharmacy Representative
Bioplus
Eddie Shadeed, 340B central regional field Director
(334) 401-1996
Signed By Date
7/17/2024
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