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ACCREDO HEALTH GROUP INC
RRC140281-00 NORTHWESTERN MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
NORTHWESTERN MEMORIAL HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC140281-00
Entity Address
251 E HURON
CHICAGO, IL 60611
Medicare Provider Number
140281
Participating Start Date
8/7/2020
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
3000 ERICSSON DRIVE, SUITE 100
WARRENDALE, PA 15086-7502
Pharmacy Comments
Contract Details
Approval Date
7/14/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matthew Joseph Flynn, VP, Finance, NMHC
(312) 926-5236
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Managing Director
(407) 852-4903
Signed By Date
7/14/2023
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