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ACCREDO HEALTH GROUP INC
CAH051328-00 TAHOE FOREST HOSPITAL
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Covered Entity Details
Entity Name
TAHOE FOREST HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH051328-00
Entity Address
10121 PINE AVENUE
TRUCKEE, CA 96161
Medicare Provider Number
051328
Participating Start Date
1/1/2011
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
1620 CENTURY CENTER PKWY
# 109
MEMPHIS, TN 38134-8849
Pharmacy Comments
Contract Details
Approval Date
7/18/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/15/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
CRYSTAL BETTS, CHIEF FINANCIAL OFFICER
(530) 582-6656
Contract Pharmacy Representative
Mary Riley, Product Manager
(217) 621-7734
Signed By Date
7/18/2017
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