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ACCREDO HEALTH GROUP INC
DSH330241 UNIVERSITY HOSPITAL
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Covered Entity Details
Entity Name
UNIVERSITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330241
Entity Address
750 East Adams Street
Syracuse, NY 13210
Medicare Provider Number
330241
Participating Start Date
7/1/2005
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
2040 W RIO SALADO PKWY STE 101B
TEMPE, AZ 85281-2010
Pharmacy Comments
Contract Details
Approval Date
4/1/2021
Contract Begin Date
4/6/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stuart M. Wright, Chief Financial Officer
(315) 464-5179
Contract Pharmacy Representative
Accredo Health Group
Piper Ann Garmon, Senior Account Executive
(901) 568-9635
Signed By Date
4/1/2021
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