340B Drug Pricing Program Database


DSH390028 UPMC MERCY (Active) - information as of 6/5/2025 2:38:47 PM

Main Details
UPMC MERCY
Disproportionate Share Hospital
No
DSH390028
390028


Additional Details
Active
11/23/2005
9/2/2008
9/2/2008
8/29/2024

Contacts

UPMC
Jonathan Petrie, CFO UPMC Magee and Mercy
(412) 578-9416

UPMC Mercy
Sandra Elizabeth Nickman, Pharmacy, Director
(724) 396-8449

Addresses

1400 LOCUST STREET
PITTSBURGH, PA 15219

UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain
PO Box 2058
Portland, OR 97208


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
9/1/09-DOC RECD TO CONFIRM ELIG DSH ADJ %; 9/17/08-ADDED BILL&SHIPPING ADDRESS; ORIG PART FROM 11/25/05 TO 3/31/08, NOT ELIG FROM 4/1/08 THRU 9/1/08, 9/2/08 NAME CHANGE (WAS PITTSBURGH MERCY HEALTH SYSTEM), MED # CHANGE (WAS 1001380890042)11/18/2009
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
PA1001380890012,1001380890043,1001380890017,100138080044,1001380890013,10013808900451881695146,1225004047,1639143084,1568526135
Shipping Addresses

UPMC MERCY OUTPATIENT PHARMACY
1622 Locust Street
Pittsburgh, PA 15219

UPMC MERCY PHARMACY
1400 LOCUST ST
PITTSBURGH, PA 15219

UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain
3175 E Carson St
Pittsburgh, PA 15203

HC Pharmacy Central
3175 E Carson St
Pittsburgh, PA 15203
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884907/12/202210/01/2022  10/16/2023
Contract DetailACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750207/12/202210/01/2022  10/16/2023
Contract DetailACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201007/12/202210/01/2022  10/16/2023
Contract DetailACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624107/12/202210/01/2022 05/31/202310/16/2023
Contract DetailACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282207/12/202210/01/2022  10/16/2023
Contract DetailACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349207/12/202210/01/2022  10/16/2023
Contract DetailADVANCED CARE SCRIPTS, INCCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 6251 CHANCELLOR DRIVE
SUITE 101 		ORLANDOFL3280901/12/202404/01/2024  04/01/2024
Contract DetailCAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361407/13/202110/01/2021  10/01/2021
Contract DetailCAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005607/13/202110/01/2021  10/01/2021
Contract DetailCAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621907/19/201710/01/2017  10/01/2017
Contract DetailCAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175707/13/202110/01/2021  10/01/2021
Contract DetailCAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808307/13/202110/01/2021  10/01/2021
Contract DetailCAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700407/13/202110/01/2021  10/01/2021
Contract DetailCAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761707/13/202110/01/2021  10/01/2021
Contract DetailCAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813307/13/202110/01/2021  10/01/2021
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237407/13/202110/01/2021  10/01/2021
Contract DetailCAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911907/13/202110/01/2021  10/01/2021
Contract DetailCHARTWELL PENNSYLVANIA1001 OAKDALE RD
OAKDALEPA15071-150210/17/201601/01/2017  10/17/2016
Contract DetailCVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870601/12/202404/01/2024  04/01/2024
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/12/202404/01/2024  04/01/2024
Contract DetailCVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502807/13/202110/01/2021  10/01/2021
Contract DetailCYSTIC FIBROSIS SERVICES, LLCDBA WALGREENS SPECIALTY PHARMACY #16280 10530 JOHN W ELLIOTT DR STE 200
FRISCOTX7503307/12/202210/01/2022 01/19/202401/19/2024
Contract DetailECKERD CORPORATIONRITE AID #10808 4937 TRANSIT ROAD
DEPEWNY1404307/12/202310/01/2023 06/15/202505/20/2025
Contract DetailECKERD CORPORATIONRITE AID #10987 100 SEVEN FIELDS BLVD
SEVEN FIELDSPA1604607/12/202310/01/2023 06/15/202505/20/2025
Contract DetailFALK PHARMACY3601 5TH AVE STE 211
PITTSBURGHPA15213-340307/12/201107/15/2011  03/28/2013
Contract DetailFORBES PHARMACY3501 FORBES AVE ROOM 756
PITTSBURGHPA1521301/12/202304/01/2023  04/01/2023
Contract DetailGIANT EAGLE PHARMACY #00021800 MCKEES ROCKS RD
MCKEES ROCKSPA1513608/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #00045055 LIBRARY RD
BETHEL PARKPA1510208/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #00053701 ROUTE 88
FINLEYVILLEPA1533208/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #00147000 OXFORD DRIVE
BETHEL PARKPA1510208/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #00176401 PENN AVE
PITTSBURGHPA1520608/15/201208/15/2012 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #00191233 BROAD ST
JOHNSTOWNPA1590607/10/202010/01/2020 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #00315260 GROVE ROAD BAPTIST & GROVE ROADS
PITTSBURGHPA1523608/15/201208/15/2012 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #0047100 SETTLERS RIDGE CENTER DR
PITTSBURGHPA1520508/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #00604010 MONROEVILLE BLVD.
MONROEVILLEPA1514608/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #00604010 MONROEVILLE BLVD.
MONROEVILLEPA1514607/13/202110/01/2021  10/01/2021
Contract DetailGIANT EAGLE PHARMACY #00612021 WHARTON ST
PITTSBURGHPA1520308/15/201208/15/2012 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #00634250 MURRAY AVENUE
PITTSBURGHPA1521707/13/202110/01/2021  10/01/2021
Contract DetailGIANT EAGLE PHARMACY #00699001 FRANKSTOWN RD
PITTSBURGHPA1523508/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #00704007 WASHINGTON ROAD
MCMURRAYPA1531708/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #00739901 MOUNTAINVIEW DRIVE
WEST MIFFLINPA1512208/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #00741165 MCKINNEY LANE PARKWAY CENTER MALL
PITTSBURGHPA1522008/15/201208/15/2012 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #0078230 RODI ROAD
PITTSBURGHPA1523508/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #0078230 RODI ROAD
PITTSBURGHPA1523507/13/202110/01/2021  10/01/2021
Contract DetailGIANT EAGLE PHARMACY #0093600 TOWNE SQUARE WAY
BRENTWOODPA1522708/15/201208/15/2012 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #0098581 PITTSBURGH RD
UNIONTOWNPA1540107/10/202010/01/2020 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #022120160 CENTER RIDGE ROAD, SUITE 201
ROCKY RIVEROH4411607/13/202110/01/2021  10/01/2021
Contract DetailGIANT EAGLE PHARMACY #12411025 WASHINGTON PIKE ROUTE 50
BRIDGEVILLEPA1501708/15/201208/15/2012 09/19/201609/28/2016
Contract DetailGIANT EAGLE PHARMACY #124651 WALSH RD
PITTSBURGHPA1520508/15/201208/15/2012 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #1619EDGEWOOD TOWNE CENTER 1705 SOUTH BRADDOCK AVE
PITTSBURGHPA1521808/15/201208/15/2012 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #2445419 S MAIN STREET
GREENVILLEPA1612507/10/202010/01/2020 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #6379420 EAST WATERFRONT DRIVE
HOMESTEADPA1512008/15/201208/15/2012 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #6379420 EAST WATERFRONT DRIVE
HOMESTEADPA1512007/13/202110/01/2021  10/01/2021
Contract DetailGIANT EAGLE PHARMACY #89912500 LOVI RD
FREEDOMPA1504207/10/202010/01/2020 04/09/202104/09/2021
Contract DetailGIANT EAGLE PHARMACY #89912500 LOVI RD
FREEDOMPA1504207/13/202110/01/2021  10/01/2021
Contract DetailHILLMAN CENTER PHARMACY5115 CENTRE AVE RM AG30.1
PITTSBURGHPA1523207/12/201107/15/2011  03/28/2013
Contract DetailONCOMED PHARMACEUTICAL SERVICES OF MA, LD/B/A ONCO360 335 BEAR HILL RD
STE 2100 		WALTHAMMA0245104/14/202207/01/2022  07/01/2022
Contract DetailONCOMED THE ONCOLOGY PHARMACY OF BUFFALOD/B/A ONCO360 140 JOHN JAMES AUDUBON PKWY STE 101
AMHERSTNY1422810/12/202101/01/2022 04/07/202204/14/2022
Contract DetailPENNSYLVANIA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04369 4610 CENTRE AVE
PITTSBURGHPA1521310/10/202301/01/2024  01/01/2024
Contract DetailPRIME THERAPEUTICS SPECIALTY PHARMACY LLALLIANCERX WALGREENS PRIME #16568 2354 COMMERCE PARK DRIVE
SUITE 100 		ORLANDOFL32819-999207/12/202210/01/2022 10/11/202210/11/2022
Contract DetailPROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514607/19/201710/01/2017  10/01/2017
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523307/13/202110/01/2021  10/01/2021
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920307/13/202110/01/2021  10/01/2021
Contract DetailPROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY OR CARELONRX SPECIALTY ONE WATERFRONT PLAZA
500 ALA MOANA BLVD., BLDG 1 		HONOLULUHI9681301/12/202404/01/2024  04/01/2024
Contract DetailPROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #48611 141 PREBLE STREET
PORTLANDME0410101/12/202404/01/2024  04/01/2024
Contract DetailPROCARE PHARMACY, L.L.C.CVS/PHARMACY #48637 2700 NORTHEAST EXPY NE STE B800
BUILDING B 		ATLANTAGA3034501/12/202404/01/2024  04/01/2024
Contract DetailRite Aid 6811701 Delran Pkwy
DelranNJ0807504/09/202507/01/2025 06/15/202505/20/2025
Contract DetailRITE AID OF PENNSYLVANIA, LLCRITE AID #7924 2270 NOBLESTOWN ROAD
PITTSBURGHPA1520507/12/202310/01/2023 06/15/202505/20/2025
Contract DetailRITE AID OF PENNSYLVANIA, LLCRITE AID #2482 300 MARKET STREET
ELIZABETHPA1503707/12/202310/01/2023 06/15/202505/20/2025
Contract DetailRITE AID OF PENNSYLVANIA, LLCRITE AID #4783 5100 LIBRARY ROAD
BETHEL PARKPA1510207/12/202310/01/2023 06/15/202505/20/2025
Contract DetailRITE AID OF PENNSYLVANIA, LLCRITE AID #1094 3210 BANKSVILLE ROAD
PITTSBURGHPA1521607/12/202310/01/2023 06/15/202505/20/2025
Contract DetailRX PARTNERS-LTC500 OLD POND RD STE 406
BRIDGEVILLEPA1501701/14/202004/01/2020 04/09/202104/09/2021
Contract DetailSINA DRUG LLCD/B/A ONCO 360 13410 EASTPOINT CENTRE DR
STE 101 		LOUISVILLEKY4022310/12/202101/01/2022  01/01/2022
Contract DetailSINA DRUG LLCDBA ONCO360 1985 MARCUS AVE STE 120
NEW HYDE PARKNY1104204/14/202207/01/2022  07/01/2022
Contract DetailTHE LANE DRUG COMPANYRITE AID #2380 975 MARKET STREET
MEADVILLEPA1633507/12/202310/01/2023 06/15/202505/20/2025
Contract DetailTHRIFT DRUG, INC.RITE AID #10967 6090 ROUTE 30
GREENSBURGPA1560107/12/202310/01/2023 06/15/202505/20/2025
Contract DetailTHRIFT DRUG, INC.RITE AID #10996 64 NORTH MERCER AVE.
SHARPSVILLEPA1615007/12/202310/01/2023 06/15/202505/20/2025
Contract DetailTHRIFT DRUG, INC.RITE AID #10910 4927 HOMEVILLE ROAD
WEST MIFFLINPA1512207/12/202310/01/2023 06/15/202505/20/2025
Contract DetailTHRIFT DRUG, INC.RITE AID #10934 2336 ARDMORE BOULEVARD
PITTSBURGHPA1522107/12/202310/01/2023 06/15/202505/20/2025
Contract DetailTHRIFT DRUG, INC.RITE AID #10950 568 CASTE VILLAGE
PITTSBURGHPA1523607/12/202310/01/2023 06/15/202505/20/2025
Contract DetailTHRIFT DRUG, INC.RITE AID #10942 410 COOKE LANE
PITTSBURGHPA1523407/12/202310/01/2023 06/15/202505/20/2025
Contract DetailUPMC CHILDRENS HOSPITAL OF PITTSBURGH4401 PENN AVE
PITTSBURGHPA15224-133407/12/201107/15/2011 05/14/202105/14/2021
Contract DetailUPMC MAGEE WOMENS HOSPITALPHARMACY DEPARTMENT 300 HALKET ST RM 4670
PITTSBURGHPA1521307/12/201107/15/2011 07/03/202407/03/2024
Contract DetailUPMC MERCY OUTPATIENT PHARMACY1622 LOCUST ST
PITTSBURGHPA1521907/03/202410/01/2024  10/01/2024
Contract DetailWAL-MART CENTRAL FILL 10-2670608 SPRING HILL DR # 3 SUITE 300
SPRINGTX7738610/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-173930 TRINITY POINT DRIVE
WASHINGTONPA1530110/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-1948400 THREE SPRINGS DR
WEIRTONWV2606210/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-2193100 MALL DRIVE
STEUBENVILLEOH4395210/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-22812351 CENTURY DR
WEST MIFFLINPA1512210/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-2300250 SUMMIT PARK DR
PITTSBURGHPA1527510/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-2420100 SARA WAY/ ROSTRAVER SQUARE
BELLE VERNONPA1501210/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-2588100 WAL-MART DRIVE
NORTH VERSAILLESPA1513710/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-4501134 DANIEL KENDALL DR
WEST BROWNSVILLEPA1541710/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-50402200 WASHINGTON PIKE
CARNEGIEPA1510610/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-53152354 COMMERCE PARK DR.
ORLANDOFL3281910/10/202301/01/2024  01/01/2024
Contract DetailWAL-MART PHARMACY 10-59979600 PARKSOUTH CT. SUITE 100
ORLANDOFL3283710/10/202301/01/2024  01/01/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 01034 112 W STEUBEN STREET
CRAFTONPA1520507/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 09187 1741 WASHINGTON RD
PITTSBURGHPA15241-120107/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 09188 4 OLD CLAIRTON RD
PLEASANT HILLSPA1523607/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 09281 5956 CENTRE AVENUE
PITTSBURGHPA15206-383007/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 09344 2455 LEECHBURG ROAD
NEW KENSINGTONPA15068-461907/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 09674 133 WEST 8TH AVE
HOMESTEADPA15120-180007/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 09675 6201 SALTSBURG ROAD
PITTSBURGHPA1523507/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 99 JEFFERSON AVE.
WASHINGTONPA15301-443407/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 4885 MCKNIGHT RD
STE 6 STE 7 		PITTSBURGHPA1523707/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS # 09803 324 HULTON ROAD
OAKMONTPA15139-191707/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 2055 OLD WASHINGTON PIKE
CARNEGIEPA1510607/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 7628 PENN AVE.
PITTSBURGHPA15221-211407/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 100 RHODE ISLAND AVE.
ROCHESTERPA15074-221407/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 100 CAVASINA DR.
CANONSBURGPA15317-176707/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 6906 UNIVERSITY BLVD.
MOON TOWNSHIPPA15108-424807/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 4900 LIBRARY RD.
BETHEL PARKPA15102-281007/12/202210/01/2022 11/15/202207/12/2023
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 4667 WILLIAM PENN HWY.
MURRYSVILLEPA1566807/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 20260 ROUTE 19
CRANBERRYPA1606607/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 234 S MAIN STREET
ZELIENOPLEPA1606307/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREEN EASTERN CO., INC.DBA: WALGREENS 100 E. MCMURRAY RD.
MCMURRAYPA15317-296207/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15438 41460 HAGGERTY CIR S
CANTONMI4818807/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #15443 10530 JOHN W ELLIOTT DR STE 100
FRISCOTX7503307/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALGREENS SPECIALTY PHARMACY, LLCDBA WALGREENS SPECIALTY PHARMACY #16287 130 ENTERPRISE DR
PITTSBURGHPA1527507/12/202210/01/2022 01/19/202401/19/2024
Contract DetailWALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275610/10/202301/01/2024  01/01/2024
Contract DetailWalmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616810/10/202301/01/2024  01/01/2024
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH390028BChildDSHUPMC MERCYUPMC Mercy Southside Outpatient Center - GI Lab2000 Mary StreetPittsburghPATerminated
DSH390028CChildDSHUPMC MERCYUPMC Mercy Southside Outpatient Center - Infusion Therapy2000 Mary StreetPittsburghPATerminated
DSH390028DChildDSHUPMC MERCYUPMC Mercy Southside Outpatient Center - Pain Mgmt2000 Mary StreetPittsburghPATerminated
DSH390028EChildDSHUPMC MERCYUPMC Mercy Southside Outpatient Center - OR2000 Mary StreetPittsburghPATerminated
DSH390028GChildDSHUPMC MERCYUPMC Mercy - SMARTH Health Greentree969 Greentree RoadPittsburghPATerminated
DSH390028HChildDSHUPMC MERCYUPMC Mercy - SH Greentree Cardio969 Greentree RoadPittsburghPATerminated
DSH390028KChildDSHUPMC MERCYUPMC Mercy Health Center Diabetes Clinic (36279)1515 Locust StreetPittsburghPATerminated
DSH390028LChildDSHUPMC MERCYUPMC Mercy Health Center - UPMC Mercy Health Center Surgical Center1515 Locust StreetPittsburghPAActive
DSH390028MChildDSHUPMC MERCYUPMC Mercy Health Center - Internal Medicine Clinic (34387)1515 Locust StreetPittsburghPAActive
DSH390028NChildDSHUPMC MERCYUPMC Mercy Health Center GI Clinic - Gastroenterology1515 Locust StreetPittsburghPATerminated
DSH390028PChildDSHUPMC MERCYMERCY - SS Collection Center - Infusion (30683)2000 Mary StreetPittsburghPATerminated
DSH390028QChildDSHUPMC MERCYWound Center - (36846)1515 Locust StreetPittsburghPAActive
DSH390028RChildDSHUPMC MERCYMERCY-SURG PAVILION - (21255)1622 Locust StreetPittsburghPAActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesShipping AddressInsertChange Request HC Pharmacy Central 3175 E Carson St Pittsburgh, PA 152035/22/2025 11:57 AM
AddressesBilling AddressUpdateGroup Change RequestPROCUREMENT: H C PHARMACY CENTRAL 3175 EAST CARSON ST. PITTSBURGH, PA 15203UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain PO Box 2058 Portland, OR 972085/6/2025 2:23 PM
AddressesShipping AddressDeleteGroup Change RequestHC PHARMACY CENTRAL 3175 E CARSON ST PITTSBURGH, PA 15203 5/6/2025 2:23 PM
AddressesShipping AddressInsertGroup Change Request UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain 3175 E Carson St Pittsburgh, PA 152035/6/2025 2:23 PM
ContactsPrimary ContactUpdatePC Change RequestSargent, Andrea DIRECTOR, PHARMACY SERVICES UPMC Mercy 4122323696Nickman, Sandra Elizabeth Pharmacy, Director UPMC Mercy 72439684493/20/2025 1:02 PM
DetailsLast Recertification DateUpdateRecertification8/26/2023 2:31:53 PM8/29/2024 2:13:04 PM8/29/2024 2:13 PM
AddressesShipping AddressUpdateChange RequestPROCUREMENT: H C PHARMACY CENTRAL 3175 EAST CARSON ST. PITTSBURGH, PA 15203HC PHARMACY CENTRAL 3175 E CARSON ST PITTSBURGH, PA 152032/14/2024 8:11 AM
AddressesShipping AddressUpdateChange RequestUPMC Mercy Health Center Pharmacy 1622 Locust Street Pittsburgh, PA 15219UPMC MERCY OUTPATIENT PHARMACY 1622 Locust Street Pittsburgh, PA 152192/14/2024 8:11 AM
AddressesShipping AddressInsertChange Request UPMC MERCY PHARMACY 1400 LOCUST ST PITTSBURGH, PA 152192/14/2024 8:11 AM
DetailsLast Recertification DateUpdateRecertification9/1/2022 2:17:11 PM8/26/2023 2:31:53 PM8/26/2023 2:31 PM
ContactsAuthorizing OfficialUpdateAO Change RequestDeems, Ron Wesley CFO Mercy and Magee UPMC 4125768808Petrie, Jonathan CFO UPMC Magee and Mercy UPMC 41257894166/20/2023 1:49 PM
AddressesShipping AddressUpdateChange RequestUPMCMercy Health Center Pharmacy 1515 Locust Street Pittsburgh, PA 15219UPMC Mercy Health Center Pharmacy 1622 Locust Street Pittsburgh, PA 152195/2/2023 6:26 AM
DetailsLast Recertification DateUpdateRecertification9/10/2021 12:22:51 PM9/1/2022 2:17:11 PM9/1/2022 2:17 PM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False8/23/2022 1:05 PM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10013808900128/23/2022 1:05 PM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA8/23/2022 1:05 PM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False8/23/2022 1:05 PM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10013808900438/23/2022 1:05 PM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA8/23/2022 1:05 PM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False8/23/2022 1:05 PM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10013808900178/23/2022 1:05 PM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA8/23/2022 1:05 PM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False8/23/2022 1:05 PM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 1001380800448/23/2022 1:05 PM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA8/23/2022 1:05 PM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False8/23/2022 1:05 PM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10013808900138/23/2022 1:05 PM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA8/23/2022 1:05 PM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False8/23/2022 1:05 PM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10013808900458/23/2022 1:05 PM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA8/23/2022 1:05 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 18816951468/23/2022 1:05 PM
Medicaid BillingNPI: StateInsertGroup Change Request PA8/23/2022 1:05 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 12250040478/23/2022 1:05 PM
Medicaid BillingNPI: StateInsertGroup Change Request PA8/23/2022 1:05 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 16391430848/23/2022 1:05 PM
Medicaid BillingNPI: StateInsertGroup Change Request PA8/23/2022 1:05 PM
Medicaid BillingNPI: NumberInsertGroup Change Request 15685261358/23/2022 1:05 PM
Medicaid BillingNPI: StateInsertGroup Change Request PA8/23/2022 1:05 PM
DetailsLast Recertification DateUpdateRecertification9/10/2020 4:40:03 PM9/10/2021 12:22:51 PM9/10/2021 12:22 PM
ContactsAuthorizing OfficialUpdateAO Change RequestBugni, Richard Director of Finance UPMC Mercy 4128028231Deems, Ron Wesley CFO Mercy and Magee UPMC 41257688081/29/2021 9:23 AM
Medicaid BillingMedicaid: NumberDeleteChange Request1001380890043 (PA) 11/24/2020 3:16 PM
Medicaid BillingMedicaid: NumberDeleteChange Request1001380890042 (PA) 11/24/2020 3:16 PM
Medicaid BillingMedicaid: NumberDeleteChange Request1001380890046 (PA) 11/24/2020 3:16 PM
Medicaid BillingMedicaid: NumberDeleteChange Request1001380890017 (PA) 11/24/2020 3:16 PM
Medicaid BillingNPI: NumberDeleteChange Request1881695146 (PA) 11/24/2020 3:16 PM
Medicaid BillingNPI: NumberDeleteChange Request1639143084 (PA) 11/24/2020 3:16 PM
Medicaid BillingNPI: NumberDeleteRecertification1770645822 ( ) 9/10/2020 4:40 PM
Medicaid BillingNPI: StateUpdateRecertification PA9/10/2020 4:40 PM
Medicaid BillingNPI: StateUpdateRecertification PA9/10/2020 4:40 PM
DetailsLast Recertification DateUpdateRecertification9/3/2019 10:23:27 AM9/10/2020 4:40:03 PM9/10/2020 4:40 PM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False9/3/2019 10:23 AM
Medicaid BillingMedicaid: NumberInsertRecertification 10013808900429/3/2019 10:23 AM
Medicaid BillingMedicaid: StateInsertRecertification PA9/3/2019 10:23 AM
Medicaid BillingMedicaid: NumberDeleteRecertification1001380890012 (PA) 9/3/2019 10:23 AM
Medicaid BillingNPI: NumberInsertRecertification 17706458229/3/2019 10:23 AM
Medicaid BillingNPI: NumberDeleteRecertification1225004047 ( ) 9/3/2019 10:23 AM
DetailsLast Recertification DateUpdateRecertification8/29/2018 3:39:03 PM9/3/2019 10:23:27 AM9/3/2019 10:23 AM
ContactsAuthorizing OfficialUpdateChange RequestSimmons, Eileen CFO Magee Womens Hospital of UPMC 4126477713Bugni, Richard Director of Finance UPMC Mercy 412802823111/19/2018 11:33 AM
DetailsLast Recertification DateUpdateRecertification12/6/2017 7:55:54 AM8/29/2018 3:39:03 PM8/29/2018 3:39 PM
DetailsLast Recertification DateUpdateRecertification8/23/2016 12:00:00 AM12/6/2017 7:55:54 AM12/6/2017 7:55 AM
ContactsAuthorizing OfficialUpdateAO Change RequestLUTTNER, SANDRA J. VP AND CFO 4122328627Simmons, Eileen CFO Magee Womens Hospital of UPMC 412647771311/21/2017 11:58 AM
ContactsPrimary ContactUpdate Sargent, Andrea DIRECTOR, PHARMACY SERVICES 4122323696Sargent, Andrea DIRECTOR, PHARMACY SERVICES UPMC Mercy 41223236969/29/2017 8:50 AM
AddressesMain AddressInsert   1400 LOCUST STREET PITTSBURGH, PA 152196/20/2017 4:17 PM
AddressesBilling AddressInsert  PROCUREMENT: H C PHARMACY CENTRAL 3175 EAST CARSON ST. PITTSBURGH, PA 152036/20/2017 4:17 PM
AddressesShipping AddressInsert  PROCUREMENT: H C PHARMACY CENTRAL 3175 EAST CARSON ST. PITTSBURGH, PA 152036/20/2017 4:17 PM
AddressesShipping AddressInsert  UPMCMercy Health Center Pharmacy 1515 Locust Street Pittsburgh, PA 152196/20/2017 4:17 PM
ContactsPrimary ContactInsert  Sargent, Andrea DIRECTOR, PHARMACY SERVICES 41223236966/20/2017 4:17 PM
Medicaid BillingMedicaid: Is PrimaryUpdate TrueFalse8/23/2016 8:34 AM
DetailsLast Recertification DateUpdate 8/25/2015 12:00:00 AM8/23/2016 12:00:00 AM8/23/2016 8:34 AM
DetailsLast Recertification DateUpdate 9/3/2014 12:00:00 AM8/25/2015 12:00:00 AM8/25/2015 3:26 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False7/30/2015 10:33 AM
Medicaid BillingMedicaid: NumberInsert  10013808900467/30/2015 10:33 AM
Medicaid BillingMedicaid: StateInsert  PA7/30/2015 10:33 AM
DetailsLast Recertification DateUpdate 9/6/2013 12:00:00 AM9/3/2014 12:00:00 AM9/3/2014 1:46 PM
DetailsLast Recertification DateUpdate 7/1/2012 12:00:00 AM9/6/2013 12:00:00 AM9/6/2013 7:53 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False5/21/2012 7:26 AM
Medicaid BillingMedicaid: NumberInsert  10013808900435/21/2012 7:26 AM
Medicaid BillingMedicaid: StateInsert  PA5/21/2012 7:26 AM
Medicaid BillingNPI: NumberInsert  18816951465/21/2012 7:26 AM
Medicaid BillingNPI: NumberInsert  12250040475/21/2012 7:26 AM
Medicaid BillingNPI: NumberInsert  16391430845/21/2012 7:26 AM
DetailsLast Recertification DateUpdate  7/1/2012 12:00:00 AM5/21/2012 7:26 AM
ContactsAuthorizing OfficialInsert  LUTTNER, SANDRA J. VP AND CFO 412232862711/18/2009 4:43 PM
DetailsLast Recertification DateInsert   11/18/2009 4:43 PM
DetailsGrant NumberInsert   11/18/2009 4:43 PM
Details340B IDInsert  DSH39002811/18/2009 4:43 PM
DetailsIs Authorizing Official EHB DataInsert   11/18/2009 4:43 PM
DatesLast Date That 340B Drugs PurchasedInsert   11/18/2009 4:43 PM
DetailsMedicare Provider NumberInsert  39002811/18/2009 4:43 PM
DetailsEntity NameInsert  UPMC MERCY11/18/2009 4:43 PM
DetailsProgram CodeInsert  DSH11/18/2009 4:43 PM
DetailsEntity SubnameInsert   11/18/2009 4:43 PM
DatesParticipating Approval DateInsert  9/2/2008 12:00:00 AM11/18/2009 4:43 PM
DetailsStateInsert  Active11/18/2009 4:43 PM
DatesRegistration DateInsert  11/23/2005 12:00:00 AM11/18/2009 4:43 PM
DatesSigned By DateInsert  8/27/2008 12:00:00 AM11/18/2009 4:43 PM
DatesStart DateInsert  9/2/2008 12:00:00 AM11/18/2009 4:43 PM
TerminationsTermination CommentsInsert   11/18/2009 4:43 PM
TerminationsTermination DateInsert   11/18/2009 4:43 PM
TerminationsTermination Effective DateInsert   11/18/2009 4:43 PM
TerminationsTermination ReasonInsert   11/18/2009 4:43 PM
DetailsComments PublicInsert  9/1/09-DOC RECD TO CONFIRM ELIG DSH ADJ %; 9/17/08-ADDED BILL&SHIPPING ADDRESS; ORIG PART FROM 11/25/05 TO 3/31/08, NOT ELIG FROM 4/1/08 THRU 9/1/08, 9/2/08 NAME CHANGE (WAS PITTSBURGH MERCY HEALTH SYSTEM), MED # CHANGE (WAS 1001380890042)11/18/2009 4:43 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False11/23/2005 6:56 AM
Medicaid BillingMedicaid: NumberInsert  100138089001211/23/2005 6:56 AM
Medicaid BillingMedicaid: StateInsert  PA11/23/2005 6:56 AM
Medicaid BillingMedicaid: Is PrimaryInsert  True11/23/2005 6:56 AM
Medicaid BillingMedicaid: NumberInsert  100138089001711/23/2005 6:56 AM
Medicaid BillingMedicaid: StateInsert  PA11/23/2005 6:56 AM