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BIOPLUS SPECIALTY PHARMACY SERVICES, LLC
SCH520011-00 LAKEVIEW MEDICAL CENTER OF RICE LAKE
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Covered Entity Details
Entity Name
LAKEVIEW MEDICAL CENTER OF RICE LAKE
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH520011-00
Entity Address
1700 WEST STOUT STREET
RICE LAKE, WI 54868
Medicare Provider Number
520011
Participating Start Date
10/1/2023
Last Recertification Date
8/21/2024
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
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Bradley Groseth, Chief Administrative Officer
(715) 236-6131
Contract Pharmacy Representative
Marshfield Clinic Health System
Girish Kaimal, Chief Pharmacy Officer
(623) 296-2075
Signed By Date
1/15/2025
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