Contract Pharmacy Details

ACCREDO HEALTH GROUP, INC.
RRC230167-00 MCLAREN GREATER LANSING

Covered Entity Details

Entity Name

MCLAREN GREATER LANSING

Subdivision Name

Type

Rural Referral Center

340B ID

RRC230167-00

Entity Address

2900 COLLINS RD.
LANSING, MI 48910

Medicare Provider Number

230167

Participating Start Date

1/1/2025

Last Recertification Date

Entity Termination Date

4/1/2025

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

11/4/2024

Contract Begin Date

1/1/2025

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2025
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Dale Thompson, Chief Financial Officer
(517) 975-7555

Contract Pharmacy Representative

Accredo
Tanielle Randall, 340B Sales Director
(407) 697-5917

Signed By Date

10/14/2024

340B Drug Pricing Program Database