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ACCREDO HEALTH GROUP, INC.
RRC270014-00 ST PATRICK HOSPITAL
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Covered Entity Details
Entity Name
ST PATRICK HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC270014-00
Entity Address
500 W. BROADWAY ST
MISSOULA, MT 59802
Medicare Provider Number
270014
Participating Start Date
7/1/2021
Last Recertification Date
8/25/2021
Entity Termination Date
10/1/2022
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
1/11/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kirk Bodlovic, Chief Operating Officer
(406) 327-1740
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/11/2019
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