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ACCREDO HEALTH GROUP, INC.
CHC07502-00 Legacy Community Health Services, Inc.
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Covered Entity Details
Entity Name
Legacy Community Health Services, Inc.
Subdivision Name
Legacy Montrose Clinic
Type
HRSA-Funded Health Center
340B ID
CHC07502-00
Entity Address
1415 California St
Houston, TX 77006-2602
Grant Number
H80CS07502
Participating Start Date
10/1/2004
Last Recertification Date
2/12/2025
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
10/3/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Hilliard, CEO
(832) 548-5277
Contract Pharmacy Representative
Accredo
Diana Florio, 340B Managing Director
(407) 988-7044
Signed By Date
10/3/2024
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