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ACCREDO HEALTH GROUP, INC.
DSH140182 ADVOCATE NORTH SIDE HEALTH NETWORK
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Covered Entity Details
Entity Name
ADVOCATE NORTH SIDE HEALTH NETWORK
Subdivision Name
DBA ADVOCATE ILLINOIS MASONIC MEDICAL CENTER (AIMMC)
Type
Disproportionate Share Hospital
340B ID
DSH140182
Entity Address
836 West Wellington Ave.
CHICAGO, IL 60657
Medicare Provider Number
140182
Participating Start Date
10/27/2005
Last Recertification Date
8/14/2024
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
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Peter Bury, VP Finance
(773) 296-7809
Contract Pharmacy Representative
Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
7/17/2018
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