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ACCREDO HEALTH GROUP, INC.
DSH370093 OU MEDICAL CENTER
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Covered Entity Details
Entity Name
OU MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH370093
Entity Address
700 NE 13TH ST.
OKLAHOMA CITY, OK 73104
Medicare Provider Number
370093
Participating Start Date
7/1/2018
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
11411 STRANG LINE RD
STE A
LENEXA, KS 66215
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
10/15/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
James Michael Watson, CFO
(405) 271-5100
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
10/15/2021
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