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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
SCH360040-00 KNOX COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
KNOX COMMUNITY HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH360040-00
Entity Address
1330 COSHOCTON AVE
MOUNT VERNON, OH 43050
Medicare Provider Number
360040
Participating Start Date
10/1/2014
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
10/11/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Danielle O'Brien, CFO
(740) 393-9623
Contract Pharmacy Representative
Knox Community Hospital
Robbi Jo Mitchell-Enderle, Director of Pharmacy
(740) 393-9008
Signed By Date
10/11/2024
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