Contract Pharmacy Details

ACCREDO HEALTH GROUP, INC.
DSH090011 MEDSTAR WASHINGTON HOSPITAL CENTER

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

4750 E 450 S
SUITE A
WHITESTOWN, IN 46075

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

340B Drug Pricing Program Database