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ACCREDO HEALTH GROUP, INC.
DSH330241 UNIVERSITY HOSPITAL
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Covered Entity Details
Entity Name
UNIVERSITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330241
Entity Address
750 East Adams Street
Syracuse, NY 13210
Medicare Provider Number
330241
Participating Start Date
7/1/2005
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
2825 W PERIMETER RD STE 112
INDIANAPOLIS, IN 46241
Pharmacy Comments
Contract Details
Approval Date
11/21/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/18/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Steven Scott, Chief Executive Officer
(315) 464-4223
Contract Pharmacy Representative
Accredo Health Group Inc.
Tony Atkinson, Sales Director
(513) 581-7562
Signed By Date
11/21/2017
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