Contract Pharmacy Details

ACCREDO HEALTH GROUP, INC.
CAH521317-00 Ascension Calumet Hospital, Inc.

Covered Entity Details

Entity Name

Ascension Calumet Hospital, Inc.

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH521317-00

Entity Address

614 MEMORIAL DRIVE
CHILTON, WI 53014

Medicare Provider Number

521317

Participating Start Date

1/1/2011

Last Recertification Date

8/19/2024

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

1/11/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Vanessa Freitag, Vice President, Pharmacy
(715) 897-1183

Contract Pharmacy Representative

Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500

Signed By Date

1/11/2022

340B Drug Pricing Program Database