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ACCREDO HEALTH GROUP, INC.
RRC150082-00 DEACONESS HOSPITAL
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Covered Entity Details
Entity Name
DEACONESS HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC150082-00
Entity Address
600 MARY STREET
EVANSVILLE, IN 47747
Medicare Provider Number
150082
Participating Start Date
10/20/2021
Last Recertification Date
8/14/2024
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
10/8/2024
Contract Begin Date
1/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Cheryl Wathen, Chief Financial Officer
(812) 450-3296
Contract Pharmacy Representative
Accredo
Diana Florio, 340B Managing Director
(407) 988-7044
Signed By Date
10/8/2024
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