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ACCREDO HEALTH GROUP, INC.
DSH180009 KING'S DAUGHTERS MEDICAL CENTER
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Covered Entity Details
Entity Name
KING'S DAUGHTERS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180009
Entity Address
2201 LEXINGTON AVENUE
ASHLAND, KY 41101
Medicare Provider Number
180009
Participating Start Date
4/1/2006
Last Recertification Date
8/22/2024
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
7/17/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sara Marks, Interim CEO
(606) 408-4401
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
7/17/2024
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