Contract Pharmacy Details

ACCREDO HEALTH GROUP, INC.
RWI761111E AIDS Healthcare Foundation

Covered Entity Details

Entity Name

AIDS Healthcare Foundation

Subdivision Name

AHF Healthcare Center - Oak Lawn

Type

Ryan White Part A

340B ID

RWI761111E

Entity Address

3920 Cedar Springs Rd.
Dallas, TX 75219

Grant Number

H89HA00014

Participating Start Date

6/13/2022

Last Recertification Date

2/20/2025

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

4/13/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/13/2024
Agreement registered in error

Contacts

Covered Entity Signing Official

Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022

Contract Pharmacy Representative

Express Scripts
Gene McCabe, 340B Sales Directo
(615) 943-7520

Signed By Date

4/13/2024

340B Drug Pricing Program Database