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ACCREDO HEALTH GROUP, INC.
DSH510007 ST. MARYS MEDICAL CENTER INC.
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Covered Entity Details
Entity Name
ST. MARYS MEDICAL CENTER INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH510007
Entity Address
2900 FIRST AVENUE
HUNTINGTON, WV 25702-1241
Medicare Provider Number
510007
Participating Start Date
7/1/2016
Last Recertification Date
9/5/2024
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
4/4/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Aaron C Blevins, Chief Pharmacy Officer
(304) 526-8250
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/4/2023
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