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ACCREDO HEALTH GROUP, INC.
DSH360112 MERCY HEALTH - ST. VINCENT MEDICAL CENTER
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Covered Entity Details
Entity Name
MERCY HEALTH - ST. VINCENT MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360112
Entity Address
2213 CHERRY STREET
TOLEDO, OH 43608
Medicare Provider Number
360112
Participating Start Date
1/1/2005
Last Recertification Date
8/27/2024
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
1/17/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Whipple, Hospital CFO
(419) 251-6935
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/17/2022
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