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ACCREDO HEALTH GROUP INC
DSH230081 MUNSON HEALTHCARE CADILLAC HOSPITAL
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Covered Entity Details
Entity Name
MUNSON HEALTHCARE CADILLAC HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH230081
Entity Address
400 HOBART ST
CADILLAC, MI 49601
Medicare Provider Number
230081
Participating Start Date
4/1/2022
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
3000 ERICSSON DRIVE, SUITE 100
WARRENDALE, PA 15086-7502
Pharmacy Comments
Contract Details
Approval Date
1/16/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kathleen Maly Maly, Interim Chief Financial Officer
(248) 885-1252
Contract Pharmacy Representative
Accredo Health Group Inc.
Tony Atkinson, Sales Director
(513) 581-7562
Signed By Date
1/16/2023
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