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ACCREDO HEALTH GROUP INC
DSH520035 AURORA HEALTH CARE CENTRAL INC.DBA AURORA SHEBOYGAN MEMORIAL MEDICAL CENTER
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Covered Entity Details
Entity Name
AURORA HEALTH CARE CENTRAL INC.DBA AURORA SHEBOYGAN MEMORIAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH520035
Entity Address
3400 UNION AVE
SHEBOYGAN, WI 53081
Medicare Provider Number
520035
Participating Start Date
7/1/2011
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
650 W GRAND AVE STE 102
ELMHURST, IL 60126-1024
Pharmacy Comments
Contract Details
Approval Date
4/11/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Nanine Nelson, SVP-Finance
(414) 299-1610
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/11/2019
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