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ACCREDO HEALTH GROUP, INC.
RWI900152G AIDS Healthcare Foundation
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Covered Entity Details
Entity Name
AIDS Healthcare Foundation
Subdivision Name
AHF Healthcare Center - Puerto RIco
Type
Ryan White Part A
340B ID
RWI900152G
Entity Address
Paseo del Prado Shopping Center
PR-3 km 8.4
Suite 107/108
Carolina, PR 00987
Grant Number
H89HA00009
Participating Start Date
7/1/2019
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
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
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