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EXPRESS SCRIPTS PHARMACY, INC.
DSH150084 ST. VINCENT HOSPITAL AND HEALTH CARE CENTER D/B/A Ascension St. Vincent Indianapolis
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Covered Entity Details
Entity Name
ST. VINCENT HOSPITAL AND HEALTH CARE CENTER D/B/A Ascension St. Vincent Indianapolis
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH150084
Entity Address
2001 WEST 86TH STREET
INDIANAPOLIS, IN 46260
Medicare Provider Number
150084
Participating Start Date
9/3/2008
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
EXPRESS SCRIPTS PHARMACY, INC.
Pharmacy Address
DBA EXPRESS SCRIPTS
4750 E. 450 S.
WHITESTOWN, IN 46075
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/20/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Aaron Joel Feldman, CEO
(317) 338-2455
Contract Pharmacy Representative
Accredo Health Group
Kristina Robinson, Contract Analyst
(407) 854-6555
Signed By Date
7/17/2018
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