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ACCREDO HEALTH GROUP, INC.
PED033302-00 PHOENIX CHILDREN'S HOSPITAL
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Covered Entity Details
Entity Name
PHOENIX CHILDREN'S HOSPITAL
Subdivision Name
Type
Children's Hospital
340B ID
PED033302-00
Entity Address
1919 E THOMAS ROAD
PHOENIX, AZ 85016
Medicare Provider Number
033302
Participating Start Date
4/1/2010
Last Recertification Date
9/19/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
6272 LEE VISTA BLVD STE 100
ORLANDO, FL 32822
Pharmacy Comments
Contract Details
Approval Date
4/13/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CRAIG MCKNIGHT, CFO
(602) 546-5468
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/13/2016
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