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ACCREDO HEALTH GROUP, INC.
CAH291313-00 Banner Churchill Community Hospital
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Covered Entity Details
Entity Name
Banner Churchill Community Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH291313-00
Entity Address
801 East Williams Avenue
Fallon, NV 89406
Medicare Provider Number
291313
Participating Start Date
7/1/2016
Last Recertification Date
8/20/2024
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
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Steven Fraker, Chief Financial Officer
(775) 867-7002
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
7/15/2019
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