| Name | Value |
|---|---|
| PROVIDER TYPE | Suppliers |
| CLASSIFICATION | Pharmacy |
| DEFINITION | A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| AREA OF SPECIALIZATION | Specialty Pharmacy |
| STATUS | Active |
| X12 CODE | 3336S0011X |
| SPECIALTY CODE | A5 |
| INDIVIDUAL/NON | NON-INDIVIDUAL |
| MASTER ENTRY FOR VUID | YES |
| VUID | 5255540 |
| EFFECTIVE DATE/TIME |
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