Covered Entity Details

CHC00074-01 Scranton Primary Health Care Center, Inc. (Active) - information as of 5/27/2025 11:42:44 PM

Main Details

Name

Scranton Primary Health Care Center, Inc.

Subdivision Name

Alder Street

Type

HRSA-Funded Health Center

Site ID

BPS-H80-020921

340B ID

CHC00074-01

Grant Number

H80CS00074

Additional Details

Current Program Status

Active

Registration Date

10/31/2017

Participating Start Date

1/1/2018

Participating Approval Date

10/31/2017

Last Recertification Date

2/11/2025

Contacts

Authorizing Official

Scranton Primary Health Care Center, Inc.
Joseph H. Hollander, Chief Executive Officer
(570) 344-3517

Primary Contact

Scranton Primary Health Care Center, Inc.
Robert Barber, CFO
(570) 344-3517 Ext: 3016

Addresses

Street Address

425 Alder Street
Scranton, PA 18505-4116

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	City	State	Zip Code	Approval Date	Begin Date	Last Updated On
Contract Detail	DEPIETRO'S PHARMACY	617 3RD ST	DUNMORE	PA	18512-2849	10/11/2021	01/01/2022	01/01/2022
Contract Detail	THE PRESCRIPTION CENTER	310 ADAMS AVE	SCRANTON	PA	18503	04/15/2019	07/01/2019	07/01/2019
Contract Detail	THE PRESCRIPTION CENTER-CHERRY STREET	329 CHERRY STREET SUITE 1A	SCRANTON	PA	18505	10/11/2021	01/01/2022	01/01/2022

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CHC00074-00	Active	BPS-H80-002129	SCRANTON PRIMARY HEALTH CARE CENTER, INC.	SCRANTON PRIMARY HEALTH CARE CENTER, INC.	959 Wyoming Ave	Scranton	PA
CHC00074-01	Active	BPS-H80-020921	Scranton Primary Health Care Center, Inc.	Alder Street	425 Alder Street	Scranton	PA
CHC00074-02	Active	BPS-H80-020964	Scranton Primary Health Care Center, Inc.	Lackawanna College	406 N Washington Ave	Scranton	PA

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CHC00074-00	DEPIETRO'S PHARMACY	617 3RD ST		DUNMORE	PA	18512-2849	07/01/2016
CHC00074-01	DEPIETRO'S PHARMACY	617 3RD ST		DUNMORE	PA	18512-2849	01/01/2022
CHC00074-02	DEPIETRO'S PHARMACY	617 3RD ST		DUNMORE	PA	18512-2849	01/01/2022
CHC00074-00	THE PRESCRIPTION CENTER	310 ADAMS AVE		SCRANTON	PA	18503	07/01/2019
CHC00074-01	THE PRESCRIPTION CENTER	310 ADAMS AVE		SCRANTON	PA	18503	07/01/2019
CHC00074-02	THE PRESCRIPTION CENTER	310 ADAMS AVE		SCRANTON	PA	18503	07/01/2019
CHC00074-00	THE PRESCRIPTION CENTER-CHERRY STREET	329 CHERRY STREET SUITE 1A		SCRANTON	PA	18505	01/01/2022
CHC00074-01	THE PRESCRIPTION CENTER-CHERRY STREET	329 CHERRY STREET SUITE 1A		SCRANTON	PA	18505	01/01/2022
CHC00074-02	THE PRESCRIPTION CENTER-CHERRY STREET	329 CHERRY STREET SUITE 1A		SCRANTON	PA	18505	01/01/2022
CHC00074-00	WALGREEN EASTERN CO., INC.	DBA: WALGREENS # 07739	330 S MAIN AVENUE	SCRANTON	PA	18504	10/01/2016	09/09/2019
CHC00074-00	WALGREEN EASTERN CO., INC.	DBA: WALGREENS	101 GREEN RIDGE ST.	SCRANTON	PA	18509	10/01/2016	09/09/2019

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/7/2024 3:40:40 PM	2/11/2025 7:52:14 AM	2/11/2025 7:52 AM
Details	Last Recertification Date	Update	Recertification	2/28/2023 7:38:50 AM	2/7/2024 3:40:40 PM	2/7/2024 3:40 PM
Contacts	Primary Contact	Update	Recertification	Barber, Robert CFO Scranton Primary Health Care Center, Inc. 5703443517	Barber, Robert CFO Scranton Primary Health Care Center, Inc. 5703443517-3016	2/28/2023 7:38 AM
Details	Last Recertification Date	Update	Recertification	1/31/2022 7:55:37 AM	2/28/2023 7:38:50 AM	2/28/2023 7:38 AM
Details	Last Recertification Date	Update	Recertification	2/8/2021 10:46:29 AM	1/31/2022 7:55:37 AM	1/31/2022 7:55 AM
Details	Last Recertification Date	Update	Recertification	1/28/2020 7:53:57 AM	2/8/2021 10:46:29 AM	2/8/2021 10:46 AM
Details	Last Recertification Date	Update	Recertification	1/29/2019 8:01:08 AM	1/28/2020 7:53:57 AM	1/28/2020 7:53 AM
Details	Last Recertification Date	Update	Recertification	2/9/2018 12:48:35 PM	1/29/2019 8:01:08 AM	1/29/2019 8:01 AM
Details	Last Recertification Date	Update	Recertification		2/9/2018 12:48:35 PM	2/9/2018 12:48 PM
Details	State	Update		Approved	Active	1/1/2018 12:00 AM
Contacts	Signed By	Insert	New Registration		Hollander, Joseph H. Chief Executive Officer Scranton Primary Health Care Center, Inc. 5703443517	10/31/2017 12:07 PM
Details	340B ID	Update	New Registration		CHC00074-01	10/31/2017 12:07 PM
Dates	Participating Approval Date	Update	New Registration		10/31/2017 12:07:03 PM	10/31/2017 12:07 PM
Details	State	Update	New Registration	Pending	Approved	10/31/2017 12:07 PM
Dates	Signed By Date	Update	New Registration		10/31/2017 10:18:26 AM	10/31/2017 12:07 PM
Dates	Start Date	Update	New Registration		1/1/2018 12:00:00 AM	10/31/2017 12:07 PM
Contacts	Primary Contact	Insert	New Registration		Barber, Robert CFO Scranton Primary Health Care Center, Inc. 5703443517	10/31/2017 10:18 AM
Addresses	Main Address	Insert	New Registration		425 Alder Street Scranton, PA 18505-4116	10/31/2017 10:18 AM
Contacts	Authorizing Official	Insert	New Registration		Hollander, Joseph H. Chief Executive Officer Scranton Primary Health Care Center, Inc. 5703443517	10/31/2017 10:18 AM
Details	Last Recertification Date	Insert	New Registration			10/31/2017 10:18 AM
Details	Grant Number	Insert	New Registration		H80CS00074	10/31/2017 10:18 AM
Details	340B ID	Insert	New Registration			10/31/2017 10:18 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			10/31/2017 10:18 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			10/31/2017 10:18 AM
Details	Medicare Provider Number	Insert	New Registration			10/31/2017 10:18 AM
Details	Entity Name	Insert	New Registration		Scranton Primary Health Care Center, Inc.	10/31/2017 10:18 AM
Details	Program Code	Insert	New Registration		CH	10/31/2017 10:18 AM
Details	Entity Subname	Insert	New Registration		Alder Street	10/31/2017 10:18 AM
Dates	Participating Approval Date	Insert	New Registration			10/31/2017 10:18 AM
Details	State	Insert	New Registration		Pending	10/31/2017 10:18 AM
Dates	Registration Date	Insert	New Registration		10/31/2017 10:18:22 AM	10/31/2017 10:18 AM
Dates	Signed By Date	Insert	New Registration			10/31/2017 10:18 AM
Dates	Start Date	Insert	New Registration			10/31/2017 10:18 AM
Terminations	Termination Comments	Insert	New Registration			10/31/2017 10:18 AM
Terminations	Termination Date	Insert	New Registration			10/31/2017 10:18 AM
Terminations	Termination Effective Date	Insert	New Registration			10/31/2017 10:18 AM
Terminations	Termination Reason	Insert	New Registration			10/31/2017 10:18 AM

340B Drug Pricing Program Database