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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
CAH131312-00 ST. LUKE'S MCCALL, LTD
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Covered Entity Details
Entity Name
ST. LUKE'S MCCALL, LTD
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH131312-00
Entity Address
1000 State Street
MCCALL, ID 83638
Medicare Provider Number
131312
Participating Start Date
1/1/2013
Last Recertification Date
8/28/2024
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
10/1/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kate Fowler, Senior VP & CFO
(208) 381-8717
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
10/1/2024
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