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ACRO PHARMACEUTICAL SERVICES LLC
DSH360112 MERCY HEALTH - ST. VINCENT MEDICAL CENTER
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Covered Entity Details
Entity Name
MERCY HEALTH - ST. VINCENT MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360112
Entity Address
2213 CHERRY STREET
TOLEDO, OH 43608
Medicare Provider Number
360112
Participating Start Date
1/1/2005
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
ACRO PHARMACEUTICAL SERVICES LLC
Pharmacy Address
ACRO PHARMACEUTICAL SERVICES LLC
313 HENDERSON DR
SHARON HILL, PA 19079
Pharmacy Comments
Contract Details
Approval Date
10/19/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/17/2019
Ownership change
Contacts
Covered Entity Signing Official
Mark S. Thompson, CFO - Toledo Region
(419) 251-0755
Contract Pharmacy Representative
Commcare
Bob Raffalo, VP Specialty Pharmacy Operations
(954) 284-2384
Signed By Date
10/19/2016
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