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ACCREDO HEALTH GROUP INC
HM683 Versiti Wisconsin, Inc.
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Covered Entity Details
Entity Name
Versiti Wisconsin, Inc.
Subdivision Name
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM683
Entity Address
638 N 18TH STREET
MILWAUKEE, WI 53233
Grant Number
H30MC24052
Participating Start Date
1/1/1997
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
650 W GRAND AVE STE 102
ELMHURST, IL 60126-1024
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Maureen Kwiecinski, Vice President Corporate Counsel
(414) 937-6418
Contract Pharmacy Representative
Accredo Health Group
Gene McCabe, 340B Sales Director
(615) 943-7500
Signed By Date
10/16/2017
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