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ACCREDO HEALTH GROUP, INC.
CH040650 PARK DUVALLE COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
PARK DUVALLE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Park DuValle Community Health Center, Inc.
Type
HRSA-Funded Health Center
340B ID
CH040650
Entity Address
3015 Wilson Ave
Louisville, KY 40211-1969
Grant Number
H80CS00083
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
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
Swannie Jett, CEO
(502) 774-4401
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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