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BIOPLUS SPECIALTY PHARMACY CA
CH010580 PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE
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Covered Entity Details
Entity Name
PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THE
Subdivision Name
PROVIDENCE COMMUNITY HEALTH CENTERS, INC.
Type
HRSA-Funded Health Center
340B ID
CH010580
Entity Address
375 Allens Ave
Providence, RI 02905-5010
Grant Number
H80CS00057
Participating Start Date
7/1/1996
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
BIOPLUS SPECIALTY PHARMACY CA
Pharmacy Address
7373 LINCOLN WAY
GARDEN GROVE, CA 92841
Pharmacy Comments
09/10/2014
Contract Details
Approval Date
1/10/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MERRILL THOMAS, CEO
(401) 444-0400 Ext: 3130
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
1/10/2025
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