340B Drug Pricing Program Database


RRC390067-69 PINNACLE HEALTH HOSPITALS (Active) - information as of 6/1/2025 4:02:26 AM

Main Details
PINNACLE HEALTH HOSPITALS
CRL - Heart Failure Center (221) - Heart Failure Clinic
Rural Referral Center
Yes
RRC390067-69
390067


Additional Details
Active
10/7/2022
1/1/2023
11/2/2022
9/6/2024

Contacts

UPMC Central PA
Greg Mitstifer, CFO
(717) 231-8245

UPMC Presbyterian Shadyside
William Zacharie Camp, 340B Manager
(740) 606-0376

Addresses

360 Alexander Spring Road
Carlisle, PA 17015

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 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
PA1000025630043,1000025630057,1000025630059,1000025630102,1000025630105,1000025630166,1000025630167,1000025630168,1000025630169,1000025630170,1000025630171,1000025630186,1000025630187,1000025630188,1000025630189,1000025630190,1000025630192,1000025630195,1000025630196,1000025630202,1000025630203,1000025630204,1000025630207,1000025630208,1000025630211,1000025630212,1000025630213,1000025630214,10000256302151164526588,1265537674,1346344769,1407813603,1922425651,1972613305,1255437638,1558731588
Shipping Addresses

UPMC Harrisburg
111 South Front Street
Harrisburg, PA 17101

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
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
RRC390067-01ChildRRCPINNACLE HEALTH HOSPITALSMSP - Med OP Onc Unit Med Ser (157) - Medical Outpatient Oncology Unit4300 LONDONDERRY ROADHARRISBURGPAActive
RRC390067-02ChildRRCPINNACLE HEALTH HOSPITALSORTENZIO CANCER CENTER (53)2020 TECHNOLOGY PARKWAYMECHANICSBURGPAActive
RRC390067-03ChildRRCPINNACLE HEALTH HOSPITALSTransplant Physicians-Gen Surg (654) - Transplant Physicians-Gen Surg (654)205 South Front StreetHarrisburgPAActive
RRC390067-04ChildRRCPINNACLE HEALTH HOSPITALSWS Anesthesia (2014) - WS Anesthesia1995 Technology ParkwayMechanicsburgPAActive
RRC390067-05ChildRRCPINNACLE HEALTH HOSPITALSWS PACU (2013) - WS PACU1995 Technology ParkwayMechanicsburgPAActive
RRC390067-06ChildRRCPINNACLE HEALTH HOSPITALSCGOH - Peri-Anesthesia Dept (412) - Peri-Anesthesia4300 Londonderry RoadHarrisburgPAActive
RRC390067-07ChildRRCPINNACLE HEALTH HOSPITALSWS Respiratory Therapy (2016) - WS Respiratory Therapy1995 Technology ParkwayMechanicsburgPAActive
RRC390067-08ChildRRCPINNACLE HEALTH HOSPITALSRad. Oncology - West Shore (51)2035 Technology ParkwayMechanicsburgPAActive
RRC390067-09ChildRRCPINNACLE HEALTH HOSPITALSWS Operating Room (2011) - WS Operating Room1995 Technology ParkwayMechanicsburgPAActive
RRC390067-10ChildRRCPINNACLE HEALTH HOSPITALSWS Noninvasive Vascular (2029) - WS Noninvasive Vascular1995 Technology ParkwayMechanicsburgPAActive
RRC390067-11ChildRRCPINNACLE HEALTH HOSPITALSWS Emergency Department (2010) - Emergency Department1995 Technology ParkwayMechanicsburgPAActive
RRC390067-12ChildRRCPINNACLE HEALTH HOSPITALSWS ECHO (2023) - WS ECHO1995 Technology ParkwayMechanicsburgPAActive
RRC390067-13ChildRRCPINNACLE HEALTH HOSPITALSRenal Transplant-Clinic (651) - Renal Transplant-Clinic205 South Front StreetHarrisburgPAActive
RRC390067-15ChildRRCPINNACLE HEALTH HOSPITALSCGOH Operating Room (411) - OR4300 Londonderry RoadHarrisburgPAActive
RRC390067-16ChildRRCPINNACLE HEALTH HOSPITALSCGOH - Endoscopy (632) - Endoscopy4300 Londonderry RoadHarrisburgPAActive
RRC390067-17ChildRRCPINNACLE HEALTH HOSPITALSCGOH - Respiratory Care (416) - Respiratory Care4300 Londonderry RoadHarrisburgPAActive
RRC390067-18ChildRRCPINNACLE HEALTH HOSPITALSFOC - Cardiology - FOHC (737) - Cardiology2015 Technology ParkwayMechanicsburgPAActive
RRC390067-19ChildRRCPINNACLE HEALTH HOSPITALSCGOH - Anesthesia (413) - Anesthesia4300 Londonderry RoadHarrisburgPAActive
RRC390067-20ChildRRCPINNACLE HEALTH HOSPITALSCGOH - Emergency Room CGH (421) - Emergency Department4300 Londonderry RoadHarrisburgPAActive
RRC390067-21ChildRRCPINNACLE HEALTH HOSPITALSMSP - Rad Oncology Med Serv Pav (52) - Radiation Oncology4300 Londonderry RoadHarrisburgPAActive
RRC390067-22ChildRRCPINNACLE HEALTH HOSPITALSBLM - Wound - East Shore Center (820) - Wound and Hyperbaric Center4310 Londonberry RoadHarrisburgPAActive
RRC390067-23ChildRRCPINNACLE HEALTH HOSPITALSFOC - Mammography PHH (887) - Mammography2015 Technology ParkwayMechanicsburgPAActive
RRC390067-24ChildRRCPINNACLE HEALTH HOSPITALSFOC - Pulmonary Diagnostic Lab-FOHC (174) - Pulmonology2015 Technology ParkwayMechanicsburgPAActive
RRC390067-25ChildRRCPINNACLE HEALTH HOSPITALSWS - WS EKG (2024) - Cardiology1995 Technology ParkwayMechanicsburgPAActive
RRC390067-26ChildRRCPINNACLE HEALTH HOSPITALSWS - WS Cardiac & Vascular (2021) - Cardiac & Vascular1995 Technology ParkwayMechanicsburgPAActive
RRC390067-27ChildRRCPINNACLE HEALTH HOSPITALSUPMC PINNACLE INFUSION CENTER - Hem/Onc Carlisle (328) - Oncology2 Jennifer CourtCarlislePAActive
RRC390067-28ChildRRCPINNACLE HEALTH HOSPITALSUPMC PINNACLE INFUSION CENTER - Hem/Onc Lititz (327) - Oncology1575 Highlands DriveLITITZPAActive
RRC390067-29ChildRRCPINNACLE HEALTH HOSPITALSWS - Cardiac Proces Unit (2032) - Cardiac Processing Unit1995 Technology ParkwayMechanicsburgPAActive
RRC390067-30ChildRRCPINNACLE HEALTH HOSPITALSWS - ED Obs Unit WSH (2041) - ED Observation1995 Technology ParkwayMechanicsburgPAActive
RRC390067-31ChildRRCPINNACLE HEALTH HOSPITALSCGOH - Echo-CGH (34) - Echo4300 Londonderry RoadHarrisburgPAActive
RRC390067-32ChildRRCPINNACLE HEALTH HOSPITALSOncology & Infusion in York (39910) - Oncology & Infusion1703 Innovation DriveYorkPAActive
RRC390067-33ChildRRCPINNACLE HEALTH HOSPITALSCGOH - Pulmonary Function (172) - Pulmonary4300 Londonderry RoadHarrisburgPAActive
RRC390067-34ChildRRCPINNACLE HEALTH HOSPITALSFOC - Pain Management - Fred (639) - Pain Management Procedure Center2005 Technology ParkwayMechanicsburgPAActive
RRC390067-35ChildRRCPINNACLE HEALTH HOSPITALSCGOH - EKG-CGH (417) - EKG4300 Londonderry RoadHarrisburgPAActive
RRC390067-36ChildRRCPINNACLE HEALTH HOSPITALSWS - MRI PHH (885) - MRI1995 Technology ParkwayMechanicsburgPAActive
RRC390067-37ChildRRCPINNACLE HEALTH HOSPITALSCGOH - Cardiac and Vascular (764) - Cardiac and Vascular4300 Londonderry RoadHarrisburgPAActive
RRC390067-38ChildRRCPINNACLE HEALTH HOSPITALSWS - Ultrasound PHH (886) - Ultrasound1995 Technology ParkwayMechanicsburgPAActive
RRC390067-39ChildRRCPINNACLE HEALTH HOSPITALSCGOH - Ultrasound PHH (886) - Ultrasound4300 Londonderry RoadHarrisburgPAActive
RRC390067-40ChildRRCPINNACLE HEALTH HOSPITALSWS - CT Scan PHH (884) - CT Scan1995 Technology ParkwayMechanicsburgPAActive
RRC390067-41ChildRRCPINNACLE HEALTH HOSPITALSCGOH - CT Scan PHH (884) - CT Scan4300 Londonderry RoadHarrisburgPAActive
RRC390067-42ChildRRCPINNACLE HEALTH HOSPITALSWS - PHH - Nuclear Medicine (734) - Nuclear Medicine1995 Technology ParkwayMechanicsburgPAActive
RRC390067-43ChildRRCPINNACLE HEALTH HOSPITALSCGOH - PHH - Nuclear Medicine (734) - Nuclear Medicine4300 Londonderry RoadHarrisburgPAActive
RRC390067-44ChildRRCPINNACLE HEALTH HOSPITALSWS - IP Diagnostic Radiology (731) - IP Diagnostic Radiology1995 Technology ParkwayMechanicsburgPAActive
RRC390067-45ChildRRCPINNACLE HEALTH HOSPITALSCGOH - IP Diagnostic Radiology (731) - Diagnostic Radiology4300 Londonderry RoadHarrisburgPAActive
RRC390067-46ChildRRCPINNACLE HEALTH HOSPITALSWS - PACU Overflow Unit (441) - PACU Overflow1995 Technology ParkwayMechanicsburgPAActive
RRC390067-47ChildRRCPINNACLE HEALTH HOSPITALSCRL - Cardiovascular Carlisle (862) - Cardiovascular360 Alexander Spring RoadCarlislePAActive
RRC390067-48ChildRRCPINNACLE HEALTH HOSPITALSLAC - Echo_Vascular - LVACC (877) - Cardiovascular1251 East Main StreetAnnvillePAActive
RRC390067-49ChildRRCPINNACLE HEALTH HOSPITALSLCV - Cardiovascular Old Post (860) - Cardiovascular2808 Old Post RoadHarrisburgPAActive
RRC390067-50ChildRRCPINNACLE HEALTH HOSPITALSMCV - Cardiovascular CenturyDr (880) - Cardiovascular900 Century DriveMechanicsburgPAActive
RRC390067-51ChildRRCPINNACLE HEALTH HOSPITALSNOC - Echo_Vascular - Newport (882) - Cardiovascular300 Bretz CourtNewportPAActive
RRC390067-52ChildRRCPINNACLE HEALTH HOSPITALSTUD - Echo Union Deposit (876) - Echo4518 Union Deposit RoadHarrisburgPAActive
RRC390067-53ChildRRCPINNACLE HEALTH HOSPITALSTPY - Cardiovascular Tech Pkwy (861) - Cardiovascular2020 Technology ParkwayMechanicsburgPAActive
RRC390067-54ChildRRCPINNACLE HEALTH HOSPITALSFOC - PHH - Nuclear Medicine (734) - Nuclear Medicine2015 Technology ParkwayMechanicsburgPAActive
RRC390067-55ChildRRCPINNACLE HEALTH HOSPITALSMSP - PHH - Nuclear Medicine (734) - Nuclear Medicine4300 Londonderry RoadHarrisburgPAActive
RRC390067-56ChildRRCPINNACLE HEALTH HOSPITALSCRL - PHH Cardiology (870) - Nuclear Medicine360 Alexander Spring RoadCarlislePAActive
RRC390067-57ChildRRCPINNACLE HEALTH HOSPITALSTUD - PHH - Nuclear Medicine (734) - Nuclear Medicine4518 Union Deposit RoadHarrisburgPAActive
RRC390067-58ChildRRCPINNACLE HEALTH HOSPITALSNOC - PHH - Nuclear Medicine (734) - Nuclear Medicine300 Bretz CourtNewportPAActive
RRC390067-59ChildRRCPINNACLE HEALTH HOSPITALSLCV - PHH Cardiology (870) - Nuclear Medicine2808 Old Post RoadHarrisburgPAActive
RRC390067-60ChildRRCPINNACLE HEALTH HOSPITALSLAC - PHH - Nuclear Medicine (734) - Nuclear Medicine1251 East Main StreetAnnvillePAActive
RRC390067-61ChildRRCPINNACLE HEALTH HOSPITALSTCH - PHH - Nuclear Medicine (734) - Nuclear Medicine240 Grandview AvenueCamp HillPAActive
RRC390067-62ChildRRCPINNACLE HEALTH HOSPITALSTPY - PHH Cardiology (870) - Nuclear Medicine2020 Technology ParkwayMechanicsburgPAActive
RRC390067-63ChildRRCPINNACLE HEALTH HOSPITALSHillman Cancer Center-Camphill (3004) - Hematology and Oncology101 Erford RoadCamp HillPATerminated
RRC390067-64ChildRRCPINNACLE HEALTH HOSPITALSGYN Oncology-York (39) - Gynecologic Oncology1703 Innovation DriveYorkPAActive
RRC390067-65ChildRRCPINNACLE HEALTH HOSPITALSWS - Endoscopy - WS (3033) - Endoscopy1995 Technology ParkwayMechanicsburgPAActive
RRC390067-66ChildRRCPINNACLE HEALTH HOSPITALSBLM - Heart Failure Center (221) - Heart Failure Clinic4310 Londonderry RoadHarrisburgPAActive
RRC390067-67ChildRRCPINNACLE HEALTH HOSPITALSFOC - Heart Failure Center (221) - Heart Failure Clinic2005 Technology ParkwayMechanicsburgPATerminated
RRC390067-68ChildRRCPINNACLE HEALTH HOSPITALSNOC - Heart Failure Center (221) - Heart Failure Clinic300 Bretz CourtNewportPAActive
RRC390067-69ChildRRCPINNACLE HEALTH HOSPITALSCRL - Heart Failure Center (221) - Heart Failure Clinic360 Alexander Spring RoadCarlislePAActive
RRC390067-70ChildRRCPINNACLE HEALTH HOSPITALSLAC HCC Infusion (3096) - Outpatient Infusion/Injection Therapies1251 East Main StreetAnnvillePAActive
RRC390067-71ChildRRCPINNACLE HEALTH HOSPITALSUPMC Community Surgery Center (3070) - Surgery Center815 Sir Thomas CourtHarrisburgPAActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesShipping AddressInsertGroup Change Request HC Pharmacy Central 3175 E Carson St Pittsburgh, PA 152035/28/2025 6:09 AM
AddressesBilling AddressUpdateGroup Change RequestUPMC Harrisburg Attn: Pharmacy 111 South Front Street Harrisburg, PA 17101UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain PO Box 2058 Portland, OR 972085/6/2025 10:29 AM
AddressesShipping AddressInsertGroup Change Request UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain 3175 E Carson St Pittsburgh, PA 152035/6/2025 10:29 AM
ContactsPrimary ContactUpdateGroup Change RequestBedell, Stephen 340B Manager UPMC 7032325693Camp, William Zacharie 340B Manager UPMC Presbyterian Shadyside 740606037610/15/2024 12:23 PM
DetailsLast Recertification DateUpdateRecertification8/16/2023 8:49:08 AM9/6/2024 3:09:15 PM9/6/2024 3:09 PM
ContactsPrimary ContactUpdateGroup Change RequestDudeck, Jennifer 340B Program Manager UPMC Central Pa. Region 7177823338Bedell, Stephen 340B Manager UPMC 703232569310/24/2023 8:19 AM
ContactsAuthorizing OfficialUpdateChange RequestBaverso, Lou President, UPMC Central PA UPMC 7172303812Mitstifer, Greg CFO UPMC Central PA 71723182458/31/2023 5:12 PM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/16/2023 8:49 AM
Medicaid BillingMedicaid: NumberInsertRecertification 10000256302148/16/2023 8:49 AM
Medicaid BillingMedicaid: StateInsertRecertification PA8/16/2023 8:49 AM
Medicaid BillingMedicaid: Is PrimaryInsertRecertification False8/16/2023 8:49 AM
Medicaid BillingMedicaid: NumberInsertRecertification 10000256302158/16/2023 8:49 AM
Medicaid BillingMedicaid: StateInsertRecertification PA8/16/2023 8:49 AM
DetailsLast Recertification DateUpdateRecertification 8/16/2023 8:49:08 AM8/16/2023 8:49 AM
ContactsPrimary ContactUpdateGroup Change RequestDunsavage, Janice Director of Pharmacy UPMC Pinnacle 7177823338Dudeck, Jennifer 340B Program Manager UPMC Central Pa. Region 71778233384/24/2023 7:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256300433/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256300573/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256300593/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301023/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301053/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301663/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301673/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301683/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301693/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301703/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301713/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301863/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301873/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301883/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301893/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301903/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301923/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301953/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256301963/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256302023/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256302033/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256302043/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256302073/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256302083/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256302113/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256302123/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingMedicaid: Is PrimaryInsertGroup Change Request False3/14/2023 11:02 AM
Medicaid BillingMedicaid: NumberInsertGroup Change Request 10000256302133/14/2023 11:02 AM
Medicaid BillingMedicaid: StateInsertGroup Change Request PA3/14/2023 11:02 AM
Medicaid BillingNPI: NumberInsertGroup Change Request 15587315883/14/2023 11:02 AM
Medicaid BillingNPI: StateInsertGroup Change Request PA3/14/2023 11:02 AM
DetailsStateUpdate ApprovedActive1/1/2023 12:01 AM
ContactsAuthorizing OfficialUpdateChange RequestBernhardt, Alison CFO UPMC Pinnacle 7172318245Baverso, Lou President, UPMC Central PA UPMC 717230381212/30/2022 9:51 AM
ContactsSigned ByInsertNew Registration Bernhardt, Alison CFO UPMC Pinnacle 717231824511/2/2022 12:40 PM
Details340B IDUpdateNew Registration RRC390067-6911/2/2022 12:40 PM
DetailsEntity NameUpdateNew RegistrationUPMC PINNACLE HOSPITALSPINNACLE HEALTH HOSPITALS11/2/2022 12:40 PM
DetailsEntity SubnameUpdateNew RegistrationCRL - Heart Failure Center (221)CRL - Heart Failure Center (221) - Heart Failure Clinic11/2/2022 12:40 PM
DatesParticipating Approval DateUpdateNew Registration 11/2/2022 12:40:50 PM11/2/2022 12:40 PM
DetailsStateUpdateNew RegistrationPendingApproved11/2/2022 12:40 PM
DatesSigned By DateUpdateNew Registration 10/7/2022 1:49:07 PM11/2/2022 12:40 PM
DatesStart DateUpdateNew Registration 1/1/2023 12:00:00 AM11/2/2022 12:40 PM
AddressesMain AddressInsertNew Registration  360 Alexander Spring Road Carlisle, PA 1701510/7/2022 1:37 PM
AddressesBilling AddressInsertNew Registration UPMC Harrisburg Attn: Pharmacy 111 South Front Street Harrisburg, PA 1710110/7/2022 1:37 PM
AddressesShipping AddressInsertNew Registration UPMC Harrisburg 111 South Front Street Harrisburg, PA 1710110/7/2022 1:37 PM
Medicaid BillingNPI: NumberInsertNew Registration 116452658810/7/2022 1:37 PM
Medicaid BillingNPI: StateInsertNew Registration PA10/7/2022 1:37 PM
Medicaid BillingNPI: NumberInsertNew Registration 126553767410/7/2022 1:37 PM
Medicaid BillingNPI: StateInsertNew Registration PA10/7/2022 1:37 PM
Medicaid BillingNPI: NumberInsertNew Registration 134634476910/7/2022 1:37 PM
Medicaid BillingNPI: StateInsertNew Registration PA10/7/2022 1:37 PM
Medicaid BillingNPI: NumberInsertNew Registration 140781360310/7/2022 1:37 PM
Medicaid BillingNPI: StateInsertNew Registration PA10/7/2022 1:37 PM
Medicaid BillingNPI: NumberInsertNew Registration 192242565110/7/2022 1:37 PM
Medicaid BillingNPI: StateInsertNew Registration PA10/7/2022 1:37 PM
Medicaid BillingNPI: NumberInsertNew Registration 197261330510/7/2022 1:37 PM
Medicaid BillingNPI: StateInsertNew Registration PA10/7/2022 1:37 PM
Medicaid BillingNPI: NumberInsertNew Registration 125543763810/7/2022 1:37 PM
Medicaid BillingNPI: StateInsertNew Registration PA10/7/2022 1:37 PM
ContactsPrimary ContactInsertNew Registration Dunsavage, Janice Director of Pharmacy UPMC Pinnacle 717782333810/7/2022 1:37 PM
ContactsAuthorizing OfficialInsertNew Registration Bernhardt, Alison CFO UPMC Pinnacle 717231824510/7/2022 1:37 PM
DetailsAssistance Received From DateInsertNew Registration  10/7/2022 1:37 PM
DetailsAssistance Received To DateInsertNew Registration  10/7/2022 1:37 PM
DetailsLast Recertification DateInsertNew Registration  10/7/2022 1:37 PM
DetailsGrant NumberInsertNew Registration  10/7/2022 1:37 PM
Details340B IDInsertNew Registration  10/7/2022 1:37 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/7/2022 1:37 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/7/2022 1:37 PM
DetailsMedicare Provider NumberInsertNew Registration 39006710/7/2022 1:37 PM
DetailsEntity NameInsertNew Registration UPMC PINNACLE HOSPITALS10/7/2022 1:37 PM
DetailsNOFO NumberInsertNew Registration  10/7/2022 1:37 PM
DetailsProgram CodeInsertNew Registration RRC10/7/2022 1:37 PM
DetailsEntity SubnameInsertNew Registration CRL - Heart Failure Center (221)10/7/2022 1:37 PM
DatesParticipating Approval DateInsertNew Registration  10/7/2022 1:37 PM
DetailsStateInsertNew Registration Pending10/7/2022 1:37 PM
DatesRegistration DateInsertNew Registration 10/7/2022 1:37:31 PM10/7/2022 1:37 PM
DatesSigned By DateInsertNew Registration  10/7/2022 1:37 PM
DatesStart DateInsertNew Registration  10/7/2022 1:37 PM
TerminationsTermination CommentsInsertNew Registration  10/7/2022 1:37 PM
TerminationsTermination DateInsertNew Registration  10/7/2022 1:37 PM
TerminationsTermination Effective DateInsertNew Registration  10/7/2022 1:37 PM
TerminationsTermination ReasonInsertNew Registration  10/7/2022 1:37 PM