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ACCREDO HEALTH GROUP INC
DSH010033 UNIVERSITY OF ALABAMA HOSPITAL
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Covered Entity Details
Entity Name
UNIVERSITY OF ALABAMA HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH010033
Entity Address
619 S. 19th Street
BIRMINGHAM, AL 35249
Medicare Provider Number
010033
Participating Start Date
12/1/1992
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
2100 RIVERCHASE CTR STE 405
HOOVER, AL 35244-1852
Pharmacy Comments
Contract Details
Approval Date
10/17/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/1/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
MARY BETH BRISCOE, CFO
(205) 975-5413
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
10/17/2016
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