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ACCREDO HEALTH GROUP, INC.
RRC460010-00 IHC Health Services Inc. dba INTERMOUNTAIN HEALTH INTERMOUNTAIN MEDICAL CENTER
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Covered Entity Details
Entity Name
IHC Health Services Inc. dba INTERMOUNTAIN HEALTH INTERMOUNTAIN MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC460010-00
Entity Address
5121 S COTTONWOOD ST
MURRAY, UT 84107
Medicare Provider Number
460010
Participating Start Date
6/8/2022
Last Recertification Date
8/21/2024
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
8/15/2022
Contract Begin Date
8/16/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Royce Stephens, Finance Director
(801) 507-7948
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
8/15/2022
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