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ACCREDO HEALTH GROUP, INC.
SCH240075-00 ST JOSEPHS MEDICAL CENTER
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Covered Entity Details
Entity Name
ST JOSEPHS MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH240075-00
Entity Address
523 N 3RD ST
BRAINERD, MN 56401
Medicare Provider Number
240075
Participating Start Date
4/1/2018
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
4/4/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael J Larson, Vice President of Operations
(218) 828-7656
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/4/2022
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