Contract Pharmacy Details

DOGWOOD PHARMACY LLC
DSH260017 PHELPS COUNTY REGIONAL MEDICAL CNTR

Covered Entity Details

Entity Name

PHELPS COUNTY REGIONAL MEDICAL CNTR

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH260017

Entity Address

1000 WEST 10TH STREET
ROLLA, MO 65401

Medicare Provider Number

260017

Participating Start Date

3/2/2021

Last Recertification Date

8/27/2024

Pharmacy Details

Pharmacy Name

DOGWOOD PHARMACY LLC

Pharmacy Address

D/B/A MEDSCRIPTS MEDICAL PHARMACY
1325 MILLER RD
STE K
GREENVILLE, SC 29607-6541

Pharmacy Comments

Contract Details

Approval Date

1/13/2025

Contract Begin Date

4/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jana Cook, Chief Financial Officer
(573) 458-7916

Contract Pharmacy Representative

BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209

Signed By Date

1/13/2025

340B Drug Pricing Program Database