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OPTION CARE ENTERPRISES, INC.
CAN360242-00 OHIO STATE UNIVERSITY JAMES CANCER HOSPITAL
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Covered Entity Details
Entity Name
OHIO STATE UNIVERSITY JAMES CANCER HOSPITAL
Subdivision Name
Type
Free Standing Cancer Hospital
340B ID
CAN360242-00
Entity Address
460 WEST 10TH AVENUE
COLUMBUS, OH 43210-1240
Medicare Provider Number
360242
Participating Start Date
4/1/2018
Last Recertification Date
8/24/2018
Entity Termination Date
1/1/2019
Pharmacy Details
Pharmacy Name
OPTION CARE ENTERPRISES, INC.
Pharmacy Address
D/B/A OPTION CARE
4380 13TH ST.
ASHLAND, KY 41102-5432
Pharmacy Comments
Contract Details
Approval Date
4/17/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Mark Larmore, Chief Financial Officer
(614) 685-9420
Contract Pharmacy Representative
Option Care Enterprises
Matthew Deans, Vice President of Business Development
(937) 478-5034
Signed By Date
4/17/2018
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