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ACCREDO HEALTH GROUP, INC.
DSH370093 OU MEDICAL CENTER
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Covered Entity Details
Entity Name
OU MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH370093
Entity Address
700 NE 13TH ST.
OKLAHOMA CITY, OK 73104
Medicare Provider Number
370093
Participating Start Date
7/1/2018
Last Recertification Date
9/4/2024
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
4/17/2023
Contract Begin Date
5/3/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Krystal L Murer, Vice President | Ethics, Regulatory Affairs, and Chief Compliance Officer
(405) 271-8052
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
4/17/2023
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