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ACCREDO HEALTH GROUP, INC.
RWI20825A Amity Medical Group, Inc
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Covered Entity Details
Entity Name
Amity Medical Group, Inc
Subdivision Name
AMG2 Park Rd location
Type
Ryan White Part A
340B ID
RWI20825A
Entity Address
10508 Park Rd Suite 130
Charlotte, NC 28210
Grant Number
H89HA11434
Participating Start Date
7/1/2019
Last Recertification Date
2/13/2025
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
1/12/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Olivia Bentley, Executive Director
(704) 968-8353
Contract Pharmacy Representative
Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/12/2022
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