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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
SCH260186-00 Lake Regional Health System
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Covered Entity Details
Entity Name
Lake Regional Health System
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH260186-00
Entity Address
54 HOSPITAL DR
Osage Beach, MO 65065-3050
Medicare Provider Number
260186
Participating Start Date
1/1/2017
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
10/19/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Paula Littleton, CFO
(573) 348-8388
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
10/19/2024
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