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ESI MAIL PHARMACY SERVICE
DSH330395 EPISCOPAL HEALTH SERVICES INC
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Covered Entity Details
Entity Name
EPISCOPAL HEALTH SERVICES INC
Subdivision Name
ST JOHN'S EPISCOPAL HOSPITAL - SOUTH SHORE
Type
Disproportionate Share Hospital
340B ID
DSH330395
Entity Address
327 BEACH 19TH STREET
FAR ROCKAWAY, NY 11691
Medicare Provider Number
330395
Participating Start Date
12/15/2005
Last Recertification Date
9/17/2024
Pharmacy Details
Pharmacy Name
ESI MAIL PHARMACY SERVICE
Pharmacy Address
DBA EXPRESS SCRIPTS
7909 S HARDY DR STE 106
TEMPE, AZ 85284-1112
Pharmacy Comments
Contract Details
Approval Date
1/7/2021
Contract Begin Date
1/11/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/23/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Gerard M. Walsh, CEO
(718) 869-7320
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/7/2021
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