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ACCREDO HEALTH GROUP, INC.
DSH140080 PRESENCE SAINT FRANCIS HOSPITAL
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Covered Entity Details
Entity Name
PRESENCE SAINT FRANCIS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH140080
Entity Address
355 RIDGE AVE.
EVANSTON, IL 60202
Medicare Provider Number
140080
Participating Start Date
7/1/2007
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
4750 E 450 S
SUITE A
WHITESTOWN, IN 46075
Pharmacy Comments
Contract Details
Approval Date
1/3/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/4/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Flavio Marin, CFO
(847) 316-4190
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/3/2022
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