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ACCREDO HEALTH GROUP, INC.
DSH330059AV MONTEFIORE MEDICAL CENTER
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Covered Entity Details
Entity Name
MONTEFIORE MEDICAL CENTER
Subdivision Name
WAKEFIELD
Type
Disproportionate Share Hospital
340B ID
DSH330059AV
Entity Address
600E 233RD ST
BRONX, NY 10466-2604
Medicare Provider Number
330059
Outpatient Facility Provider Number
Participating Start Date
10/1/2015
Last Recertification Date
9/16/2022
Entity Termination Date
10/1/2023
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP, INC.
Pharmacy Address
2 BOULDEN CIR STE 1
NEW CASTLE, DE 19720-3492
Pharmacy Comments
Contract Details
Approval Date
1/12/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Colleen M. Blye, Executive Vice President-CFO
(718) 920-7602
Contract Pharmacy Representative
Express Scripts
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/12/2018
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