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ACCREDO HEALTH GROUP, INC.
DSH010091 GROVE HILL MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
GROVE HILL MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH010091
Entity Address
295 SOUTH JACKSON STREET
GROVE HILL, AL 36451
Medicare Provider Number
010091
Participating Start Date
1/1/2020
Last Recertification Date
8/27/2024
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
7/14/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/27/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kenneth Larrimore, COO
(251) 275-3191
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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