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OPTION CARE ENTERPRISES, INC.
SCH050352-00 BARTON MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
BARTON MEMORIAL HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH050352-00
Entity Address
2170 SOUTH AVENUE
SOUTH LAKE TAHOE, CA 96158
Medicare Provider Number
050352
Participating Start Date
7/1/2023
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
OPTION CARE ENTERPRISES, INC.
Pharmacy Address
OPTION CARE
7300 S. VIRGINIA ST.
SUITE A
RENO, NV 89511-1111
Pharmacy Comments
Contract Details
Approval Date
10/13/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/8/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Dick Derby, CFO
(530) 543-5841
Contract Pharmacy Representative
Ron Vaught, General Manager
(775) 828-8200
Signed By Date
10/13/2016
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