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ACCREDO HEALTH GROUP, INC.
CH05320AH HealthNet, Inc.
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Covered Entity Details
Entity Name
HealthNet, Inc.
Subdivision Name
Crispus Attucks Clinic
Type
HRSA-Funded Health Center
340B ID
CH05320AH
Entity Address
1140 Dr Martin Luther King Jr St
Rm 615
Indianapolis, IN 46202-2221
Grant Number
H80CS00114
Participating Start Date
1/1/2022
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
6272 LEE VISTA BLVD STE 100
ORLANDO, FL 32822
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Varon Edward Cantrell, Chief Medical Officer
(317) 957-2015
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
4/15/2024
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