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ACCREDO HEALTH GROUP, INC.
DSH030065 BANNER DESERT MEDICAL CENTER
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Covered Entity Details
Entity Name
BANNER DESERT MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH030065
Entity Address
1400 SOUTH DOBSON ROAD
MESA, AZ 85202
Medicare Provider Number
030065
Participating Start Date
1/1/2007
Last Recertification Date
8/12/2024
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
7/17/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cheryl A Tong, CFO
(602) 865-5751
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
7/17/2019
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