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ACCREDO HEALTH GROUP, INC.
CAH161374-00 SHELBY CO CHRIS A MYRTUE MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
SHELBY CO CHRIS A MYRTUE MEMORIAL HOSPITAL
Subdivision Name
DBA MYRTUE MEDICAL CENTER
Type
Critical Access Hospital
340B ID
CAH161374-00
Entity Address
1213 GARFIELD AVE
HARLAN, IA 51537
Medicare Provider Number
161374
Participating Start Date
4/1/2011
Last Recertification Date
8/19/2024
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
1/18/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Barry Jacobsen, CEO
(712) 755-4315
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/18/2022
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