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ACCREDO HEALTH GROUP, INC.
DSH330059BM MONTEFIORE MEDICAL CENTER
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Covered Entity Details
Entity Name
MONTEFIORE MEDICAL CENTER
Subdivision Name
Hutchinson Metro Center - Medicine Sub-Specialties
Type
Disproportionate Share Hospital
340B ID
DSH330059BM
Entity Address
1250 Waters Place
Bronx, NY 10461
Medicare Provider Number
330059
Outpatient Facility Provider Number
Participating Start Date
4/1/2018
Last Recertification Date
9/6/2024
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
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
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
4/16/2018
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