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ACCREDO HEALTH GROUP, INC.
DSH220177 NANTUCKET COTTAGE HOSPITAL
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Covered Entity Details
Entity Name
NANTUCKET COTTAGE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH220177
Entity Address
57 PROSPECT STREET
NANTUCKET, MA 02554-2799
Medicare Provider Number
220177
Participating Start Date
3/15/2022
Last Recertification Date
9/8/2023
Entity Termination Date
4/1/2024
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
10/13/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Aaron S Fishman, VP, Finance
(508) 825-8205
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Senior Director 340B sales
(615) 943-7500
Signed By Date
10/13/2022
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