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ACCREDO HEALTH GROUP, INC.
STD71103 Gastrointestinal Specialists AMC
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Covered Entity Details
Entity Name
Gastrointestinal Specialists AMC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD71103
Entity Address
3217 Mabel Street
Shreveport, LA 71103
Grant Number
NU62PS924522
Participating Start Date
10/1/2024
Last Recertification Date
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
8/7/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Adi Darsi, CEO
(318) 213-4536
Contract Pharmacy Representative
Accredo
Travis Behrens, Managing Director
(314) 486-5839
Signed By Date
7/15/2024
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