340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ACCREDO HEALTH GROUP, INC.
CAH021306-00 PROVIDENCE KODIAK ISLAND MEDICAL CENTER
Print
Covered Entity Details
Entity Name
PROVIDENCE KODIAK ISLAND MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH021306-00
Entity Address
1915 E REZANOF DRIVE
ATTN PHARMACY
KODIAK, AK 99615
Medicare Provider Number
021306
Participating Start Date
1/1/2011
Last Recertification Date
8/13/2024
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
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/16/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Karl E Hertz, Administrator
(907) 486-9567
Contract Pharmacy Representative
Accredo
Casey Spiess, Director, 340B Business Development
(314) 486-5839
Signed By Date
10/15/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session