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INDIANA UNIVERSITY HEALTH, INC
RRC150173-00 IU HEALTH ARNETT HOSPITAL
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Covered Entity Details
Entity Name
IU HEALTH ARNETT HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC150173-00
Entity Address
5165 MCCARTY LANE
LAFAYETTE, IN 47905
Medicare Provider Number
150173
Participating Start Date
5/3/2023
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
INDIANA UNIVERSITY HEALTH, INC
Pharmacy Address
DBA: IU HEALTH ADVANCED THERAPIES PHARMA
390 AIRTECH PKWY STE 106A
PLAINFIELD, IN 46168
Pharmacy Comments
Contract Details
Approval Date
7/13/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jennifer M. Alvey, SVP & CFO
(317) 963-0213
Contract Pharmacy Representative
IU Health
Pat Sorgen, Director- Pharmacy
(317) 312-4516
Signed By Date
7/13/2023
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