Contract Pharmacy Details

THE TOWERS PHARMACY
DSH100093 BAPTIST HOSPITAL

Covered Entity Details

Entity Name

BAPTIST HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH100093

Entity Address

123 Baptist Way
PENSACOLA, FL 32503

Medicare Provider Number

100093

Participating Start Date

4/1/2009

Last Recertification Date

8/28/2024

Pharmacy Details

Pharmacy Name

THE TOWERS PHARMACY

Pharmacy Address

125 BAPTIST WAY STE 1F
PENSACOLA, FL 32503

Pharmacy Comments

Contract Details

Approval Date

4/1/2009

Contract Begin Date

4/1/2009

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

JOHN T. PORTER, PRESIDENT
(850) 434-4989

Contract Pharmacy Representative

JOHN T. PORTER, PRESIDENT
(850) 434-4522

Signed By Date

11/24/2008