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ACCREDO HEALTH GROUP INC
DSH190098 University Health Shreveport, LLC
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Covered Entity Details
Entity Name
University Health Shreveport, LLC
Subdivision Name
UNIVERSITY HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH190098
Entity Address
1541 KINGS HIGHWAY
SHREVEPORT, LA 71103
Medicare Provider Number
190098
Participating Start Date
1/1/1998
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
520 ELMWOOD PARK BLVD STE 100
NEW ORLEANS, LA 70123-6826
Pharmacy Comments
Contract Details
Approval Date
1/8/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark Randolph, President
(318) 626-0982
Contract Pharmacy Representative
Accredo Health Group Inc
Stephen Swarter, Sr. Buyer
(302) 395-8946
Signed By Date
1/8/2018
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