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ESI MAIL PHARMACY SERVICE
DSH360048 UNIV OF TOLEDO MEDL CENTER
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Covered Entity Details
Entity Name
UNIV OF TOLEDO MEDL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH360048
Entity Address
3000 ARLINGTON AVENUE
TOLEDO, OH 43614-2589
Medicare Provider Number
360048
Participating Start Date
4/1/2016
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
ESI MAIL PHARMACY SERVICE
Pharmacy Address
DBA EXPRESS SCRIPTS
7909 S HARDY DR STE 106
TEMPE, AZ 85284-1112
Pharmacy Comments
Contract Details
Approval Date
4/19/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Russell Wayne Smith, Senior Hospital Administrator
(419) 383-3788
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/19/2022
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