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BIOPLUS SPECIALTY INFUSION AL LLC
RRC180104-00 BAPTIST HEALTH PADUCAH
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Covered Entity Details
Entity Name
BAPTIST HEALTH PADUCAH
Subdivision Name
Type
Rural Referral Center
340B ID
RRC180104-00
Entity Address
2501 KENTUCKY AVENUE
PADUCAH, KY 42003
Medicare Provider Number
180104
Participating Start Date
1/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
BIOPLUS SPECIALTY INFUSION AL LLC
Pharmacy Address
2511 ROSS CLARK CIR
DOTHAN, AL 36301
Pharmacy Comments
Contract Details
Approval Date
4/14/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/22/2025
Agreement registered in error
Contacts
Covered Entity Signing Official
Kenneth Boyd, President
(270) 575-2101
Contract Pharmacy Representative
Bioplus
Bill Cook, Executive VP of Sales
(866) 840-4067
Signed By Date
4/14/2025
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