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ACCREDO HEALTH GROUP INC
CAH321300-00 SIERRA VISTA HOSPITAL
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Covered Entity Details
Entity Name
SIERRA VISTA HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH321300-00
Entity Address
800 EAST 9TH AVE.
TRUTH OR CONSEQUENCES, NM 87901-1961
Medicare Provider Number
321300
Participating Start Date
7/1/2018
Last Recertification Date
8/15/2024
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
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Eric Lee Stokes, CEO
(575) 894-2111
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
7/15/2021
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