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ACCREDO HEALTH GROUP, INC.
DSH330194 MAIMONIDES MEDICAL CENTER
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Covered Entity Details
Entity Name
MAIMONIDES MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330194
Entity Address
4802 TENTH AVE.
BROOKLYN, NY 11219
Medicare Provider Number
330194
Participating Start Date
10/1/2004
Last Recertification Date
8/30/2024
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
1/14/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
KENNETH D. GIBBS, CEO
(718) 283-6575
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/14/2019
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