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ACCREDO HEALTH GROUP, INC.
PED103301-00 Nicklaus Children's Hospital
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Covered Entity Details
Entity Name
Nicklaus Children's Hospital
Subdivision Name
Type
Children's Hospital
340B ID
PED103301-00
Entity Address
3100 SW 62nd Avenue
Miami, FL 33155
Medicare Provider Number
103301
Participating Start Date
10/1/2011
Last Recertification Date
8/30/2024
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
4/1/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dawn Javersack, Sr. Vice President and Chief Financial Officer
(786) 624-2005
Contract Pharmacy Representative
Accredo
Diana Florio, 340B Managing Director
(407) 988-7044
Signed By Date
4/1/2025
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