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ACCREDO HEALTH GROUP INC
CAH051318-00 St Joseph Health Northern California LLC- DBA Redwood Memorial Hospital
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Covered Entity Details
Entity Name
St Joseph Health Northern California LLC- DBA Redwood Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH051318-00
Entity Address
3300 Renner Drive
Fortuna, CA 95540
Medicare Provider Number
051318
Participating Start Date
4/1/2012
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
1620 CENTURY CENTER PKWY
# 109
MEMPHIS, TN 38134-8849
Pharmacy Comments
Contract Details
Approval Date
1/8/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/15/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kevin Klockenga, CEO
(707) 522-1520
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/8/2020
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