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ACCREDO HEALTH GROUP, INC.
DSH090011 MEDSTAR WASHINGTON HOSPITAL CENTER
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Covered Entity Details
Entity Name
MEDSTAR WASHINGTON HOSPITAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH090011
Entity Address
110 IRVING STREET, NW
WASHINGTON, DC 20010
Medicare Provider Number
090011
Participating Start Date
1/1/2005
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
2 BOULDEN CIR STE 1
NEW CASTLE, DE 19720-3492
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
William J Gayne, Chief Financial Officer
(202) 877-6147
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
1/16/2024
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