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ACCREDO HEALTH GROUP, INC.
DSH450184 MEMORIAL HERMANN HOSPITAL SYSTEM
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Covered Entity Details
Entity Name
MEMORIAL HERMANN HOSPITAL SYSTEM
Subdivision Name
Memorial Hermann Southwest Hospital
Type
Disproportionate Share Hospital
340B ID
DSH450184
Entity Address
7600 Beechnut
Houston, TX 77074
Medicare Provider Number
450184
Participating Start Date
2/7/2018
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
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/14/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Rebecca Tucker, VP, Finance
(713) 456-5340
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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