340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BAYCARE HOME CARE, INC.
DSH100075A ST JOSEPH'S HOSPITAL
Print
Covered Entity Details
Entity Name
ST JOSEPH'S HOSPITAL
Subdivision Name
ST JOSEPH'S HOSPITAL- NORTH
Type
Disproportionate Share Hospital
340B ID
DSH100075A
Entity Address
4211 VAN DYKE ROAD
LUTZ, FL 33558
Medicare Provider Number
100075
Outpatient Facility Provider Number
Participating Start Date
4/1/2010
Last Recertification Date
8/31/2015
Entity Termination Date
4/1/2016
Pharmacy Details
Pharmacy Name
BAYCARE HOME CARE, INC.
Pharmacy Address
D/B/A BAYCARE PHARMACY
3003 W DR MARTIN LUTHER KING JR. BLVD
TAMPA, FL 33607
Pharmacy Comments
Contract Details
Approval Date
10/10/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2016
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Lorraine Lutton, President, St. Joseph's Hospital
(813) 870-4020
Contract Pharmacy Representative
Iqbal Burney, Director of Pharmacy
(727) 394-6577
Signed By Date
10/10/2013
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session