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ACCREDO HEALTH GROUP, INC.
DSH120022 STRAUB CLINIC & HOSPITAL
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Covered Entity Details
Entity Name
STRAUB CLINIC & HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH120022
Entity Address
888 S. KING STREET
HONOLULU, HI 96813
Medicare Provider Number
120022
Participating Start Date
4/1/2025
Last Recertification Date
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
1/29/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David E Stumbaugh, VP, Supply Chain Management and Pharmacy
(808) 522-6946
Contract Pharmacy Representative
Accredo Health Group, Inc.
Travis Behrens, Lead Director, 340B Client Sales
(407) 988-7044
Signed By Date
1/13/2025
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