340B Drug Pricing Program Database
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ACCREDO HEALTH GROUP, INC.
DSH500050 PeaceHealth Southwest Medical Center
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Covered Entity Details
Entity Name
PeaceHealth Southwest Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500050
Entity Address
400 NE Mother Joseph Place
VANCOUVER, WA 98664
Medicare Provider Number
500050
Participating Start Date
4/1/2005
Last Recertification Date
8/14/2024
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
10/18/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/22/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Renato V. Baciarelli, SVP, Operations & System Services
(360) 729-1117
Contract Pharmacy Representative
Accredo Health Group
Gene McCabe, 340B Sales Director
(615) 943-7500
Signed By Date
10/18/2016
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