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ACCREDO HEALTH GROUP, INC.
PED363306-00 Dayton Children's Hospital
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Covered Entity Details
Entity Name
Dayton Children's Hospital
Subdivision Name
Type
Children's Hospital
340B ID
PED363306-00
Entity Address
1 CHILDREN'S PLAZA
DAYTON, OH 45404
Medicare Provider Number
363306
Participating Start Date
4/1/2010
Last Recertification Date
8/29/2024
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
4/21/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Benjamin Goodstein, VICE PRESIDENT and Chief Ambulatory Officer
(937) 641-3450
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/21/2023
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