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ACCREDO HEALTH GROUP, INC.
RRC390045-00 WILLIAMSPORT HOSPITAL & MEDICAL CTR
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Covered Entity Details
Entity Name
WILLIAMSPORT HOSPITAL & MEDICAL CTR
Subdivision Name
Type
Rural Referral Center
340B ID
RRC390045-00
Entity Address
700 HIGH STREET
WILLIAMSPORT, PA 17701
Medicare Provider Number
390045
Participating Start Date
10/1/2024
Last Recertification Date
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
7/14/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Christopher Stockhausen, CFO
(412) 664-2528
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
7/14/2022
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