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ACCREDO HEALTH GROUP, INC.
FQHCLA425C SUNRISE CLINICS
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Covered Entity Details
Entity Name
SUNRISE CLINICS
Subdivision Name
Tucumcari High School School Based Clinic
Type
Health Center Program Look-Alike
340B ID
FQHCLA425C
Entity Address
1001 S 7th Street, Nurse Office FL 1
Tucumcari, NM 88401
Grant Number
LALCS40211
Participating Start Date
7/1/2021
Last Recertification Date
2/11/2025
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
1/26/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Randal Brown, CEO
(575) 472-4311
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Senior Director 340B sales
(615) 943-7500
Signed By Date
1/26/2022
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