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ACCREDO HEALTH GROUP, INC.
DSH050077 SCRIPPS MERCY HOSPITAL
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Covered Entity Details
Entity Name
SCRIPPS MERCY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050077
Entity Address
4077 FIFTH AVENUE
SAN DIEGO, CA 92103
Medicare Provider Number
050077
Participating Start Date
1/1/2005
Last Recertification Date
8/27/2024
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
1/13/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/30/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tom Gammiere, CEO
(619) 260-7101
Contract Pharmacy Representative
Accredo
Krista A Huck, Account Director
(619) 455-3269
Signed By Date
1/13/2021
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