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ACCREDO HEALTH GROUP, INC.
DSH440131 BAPTIST MEMORIAL HOSPITAL- TIPTON
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Covered Entity Details
Entity Name
BAPTIST MEMORIAL HOSPITAL- TIPTON
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH440131
Entity Address
1995 HIGHWAY 51 S
COVINGTON, TN 38019-2338
Medicare Provider Number
440131
Participating Start Date
9/4/2008
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
2 BOULDEN CIR STE 1
NEW CASTLE, DE 19720-3492
Pharmacy Comments
Contract Details
Approval Date
4/23/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Barham, VP, Operations Finance CFO
(901) 227-7467
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/23/2018
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