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EXPRESS SCRIPTS
CAH171350-00 Russell Regional Hospital
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Covered Entity Details
Entity Name
Russell Regional Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171350-00
Entity Address
200 S. Main Street
Russell, KS 67665
Medicare Provider Number
171350
Participating Start Date
7/1/2014
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
EXPRESS SCRIPTS
Pharmacy Address
ESI MAIL PHARMACY SERVICE INC
4600 N HANLEY RD
SAINT LOUIS, MO 63134
Pharmacy Comments
Contract Details
Approval Date
10/12/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David Paul Caudill, CEO
(785) 483-0708
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
10/12/2023
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