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ACCREDO HEALTH GROUP INC
DSH050441 STANFORD HEALTH CARE
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Covered Entity Details
Entity Name
STANFORD HEALTH CARE
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050441
Entity Address
300 PASTEUR DRIVE
Stanford, CA 94305
Medicare Provider Number
050441
Participating Start Date
7/1/2015
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
ACCREDO HEALTH GROUP INC
Pharmacy Address
2040 W RIO SALADO PKWY STE 101B
TEMPE, AZ 85281-2010
Pharmacy Comments
Contract Details
Approval Date
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/7/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Linda Hoff, CFO
(650) 497-0391
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
4/16/2018
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