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ACCREDO HEALTH GROUP, INC.
DSH410010 WOMEN & INFANTS HOSPITAL OF RHODE ISLAND
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Covered Entity Details
Entity Name
WOMEN & INFANTS HOSPITAL OF RHODE ISLAND
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH410010
Entity Address
101 DUDLEY ST.
PROVIDENCE, RI 02905
Medicare Provider Number
410010
Participating Start Date
10/1/2004
Last Recertification Date
8/26/2024
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
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas P Ricci, VP Finance
(401) 430-1286
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
10/16/2023
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