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ACCREDO HEALTH GROUP, INC.
HV00142A UKSM-W MEDICAL PRACTICE ASSOCIATION
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Covered Entity Details
Entity Name
UKSM-W MEDICAL PRACTICE ASSOCIATION
Subdivision Name
Type
Ryan White Part C
340B ID
HV00142A
Entity Address
712 A St John Street
Garden City, KS 67846
Grant Number
H76HA00142
Participating Start Date
4/1/2020
Last Recertification Date
2/7/2024
Entity Termination Date
4/1/2025
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
10/19/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/27/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Aaron Ryan, ADMINISTRATOR
(316) 293-3526
Contract Pharmacy Representative
Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
10/19/2020
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