340B Drug Pricing Program Database
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ACCREDO HEALTH GROUP, INC.
DSH490002 RUSSELL COUNTY HOSPITAL
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Covered Entity Details
Entity Name
RUSSELL COUNTY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH490002
Entity Address
58 Carroll Street
LEBANON, VA 24266
Medicare Provider Number
490002
Participating Start Date
4/22/2020
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
4/18/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shane Hilton, EVP, Chief Financial Officer
(423) 302-3467
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/18/2023
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