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ACCREDO HEALTH GROUP, INC.
PED243300-00 GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
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Covered Entity Details
Entity Name
GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
Subdivision Name
Type
Children's Hospital
340B ID
PED243300-00
Entity Address
200 UNIVERSITY AVENUE EAST
ST. PAUL, MN 55101
Medicare Provider Number
243300
Participating Start Date
7/1/2019
Last Recertification Date
8/19/2024
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
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patrick Michael Nolan, Chief Financial Officer
(651) 312-3105
Contract Pharmacy Representative
Gillette Children's Specialty Healthcare - Saint Paul, MN
Kristen Beyer, Pharmacy Manager
(651) 726-2876
Signed By Date
7/14/2021
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