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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
DSH180035 ST ELIZABETH HEALTHCARE
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Covered Entity Details
Entity Name
ST ELIZABETH HEALTHCARE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180035
Entity Address
1 MEDICAL VILLAGE DRIVE
EDGEWOOD, KY 41017-3403
Medicare Provider Number
180035
Participating Start Date
10/1/2016
Last Recertification Date
8/20/2024
Entity Termination Date
4/1/2025
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
10/15/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lori Ritchey-Baldwin, CFO
(859) 655-1642
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
10/15/2024
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