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ACCREDO HEALTH GROUP INC
FQHCLA390 MERCY MEDICAL HEALTH CENTER
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Covered Entity Details
Entity Name
MERCY MEDICAL HEALTH CENTER
Subdivision Name
Mercy Medical Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA390
Entity Address
244 Bond Street
Jonesboro, LA 71251
Grant Number
LALCS31662
Participating Start Date
7/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
2040 W RIO SALADO PKWY STE 101B
TEMPE, AZ 85281-2010
Pharmacy Comments
Contract Details
Approval Date
1/2/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kimberly Lynn Brunson, CEO
(318) 259-1100
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
1/2/2024
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