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OPTION CARE ENTERPRISES, INC.
CAH501333-00 KITTITAS COUNTY PUBLIC HOSPITAL DISTRICT #1
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Covered Entity Details
Entity Name
KITTITAS COUNTY PUBLIC HOSPITAL DISTRICT #1
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH501333-00
Entity Address
603 S CHESTNUT ST
ELLENSBURG, WA 98926
Medicare Provider Number
501333
Participating Start Date
8/25/2010
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
OPTION CARE ENTERPRISES, INC.
Pharmacy Address
D/B/A OPTION CARE
11403 BLUEGRASS PARKWAY
SUITE 400
LOUISVILLE, KY 40299-2398
Pharmacy Comments
Contract Details
Approval Date
4/22/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/2/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
PAUL NURICK, CEO
(509) 962-7301
Contract Pharmacy Representative
Option Care
David Schulta, General Manager
(502) 266-0123
Signed By Date
4/22/2016
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