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ACCREDO HEALTH GROUP, INC.
DSH300012 ELLIOT HOSPITAL
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Covered Entity Details
Entity Name
ELLIOT HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH300012
Entity Address
1 ELLIOT WAY
MANCHESTER, NH 03103
Medicare Provider Number
300012
Participating Start Date
3/12/2021
Last Recertification Date
9/14/2022
Entity Termination Date
1/1/2023
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
4/15/2021
Contract Begin Date
4/20/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Joseph Tate Curti, COO
(603) 663-2082
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/15/2021
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