340B Drug Pricing Program Database


PED393302-40 UPMC CHILDREN'S HOSPITAL OF PITTSBURGH (Active) - information as of 6/11/2025 7:18:45 PM

Main Details
UPMC CHILDREN'S HOSPITAL OF PITTSBURGH
CHP-Pulmonology North - (31315)
Children's Hospital
No
PED393302-40
393302


Additional Details
Active
10/10/2023
1/1/2024
11/27/2023
9/6/2024

Contacts

UPMC
Mario Edward Wilfong, CFO
(412) 692-8201

UPMC
Amanda Pell, Manager, 340B Program
(814) 771-8354

Addresses

2599 Wexford-Bayne Road
Wexford, PA 15143

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
PA1007347990017,1007347990012,1007347990004,1007347990059,1007347990089,1007347990060,10073479900691619313350,1194889485,1083851968,1053476556,1164426896
Shipping Addresses

HC PHARMACY CENTRAL - PROCUREMENT
3175 E. CARSON ST
Pittsburgh, PA 15203

UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain
3175 E Carson St
Pittsburgh, PA 15203
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
PED393302-01ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHOutpatient Surgery2599 WEXFORD BAYNE ROADSEWICKLEYPATerminated
PED393302-02ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSOUTH SATELLITE205 Millers Run RoadBRIDGEVILLEPATerminated
PED393302-03ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSAME DAY SURGERY-MAIN HOSPITAL (SPU)4401 PENN AVENUEPITTSBURGHPATerminated
PED393302-04ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHEAST SATELLITE4055 MONROEVILLE BLVD.MONROEVILLEPATerminated
PED393302-05ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHRENAL CLINIC4401 PENN AVENUEPITTSBURGHPATerminated
PED393302-06ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSouth Satellite/Communication Disorders205 Millers Run RoadBridgevillePATerminated
PED393302-07ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSouth Satellite/Phlebotomy Services205 Millers Run RoadBridgevillePATerminated
PED393302-08ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSouth Satellite/Radiology Diagnostic205 Millers Run RoadBridgevillePATerminated
PED393302-09ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSouth Satellite/Occupational Therapy205 Millers Run RoadBridgevillePATerminated
PED393302-10ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSouth Satellite/Physical Therapy205 Millers Run RoadBridgevillePATerminated
PED393302-11ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSouth Satellite/Pulmonary Function205 Millers Run RoadBridgevillePATerminated
PED393302-12ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSouth Satellite/Electroencephalography205 Millers Run RoadBridgevillePATerminated
PED393302-13ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSouth Satellite/EKG / ECHO205 Millers Run RoadBridgevillePATerminated
PED393302-14ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHSouth Satellite/Audiology205 Millers Run RoadBridgevillePATerminated
PED393302-15ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHEast Satellite/Electroencephalography4055 Monroeville BoulevardMonroevillePATerminated
PED393302-16ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHEast Satellite/Phlebotomy Services4055 Monroeville BoulevardMonroevillePATerminated
PED393302-17ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHEast Satellite/Pulmonary Function4055 Monroeville BoulevardMonroevillePATerminated
PED393302-18ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHEast Satellite/EKG / ECHO4055 Monroeville BoulevardMonroevillePATerminated
PED393302-19ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHEast Satellite/Occupational Therapy4055 Monroeville BoulevardMonroevillePATerminated
PED393302-20ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHEast Satellite/Physical Therapy4055 Monroeville BoulevardMonroevillePATerminated
PED393302-21ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHEast Satellite/Radiology Diagnostic4055 Monroeville BoulevardMonroevillePATerminated
PED393302-22ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHEast Satellite/Communication Disorders4055 Monroeville BoulevardMonroevillePATerminated
PED393302-23ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHEast Satellite/Audiology4055 Monroeville BoulevardMonroevillePATerminated
PED393302-24ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Ronald McDonald Care Mobile2559 Wexford-Bayne RoadSewickleyPATerminated
PED393302-25ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Phlebotomy Services11279 Perry HighwayWexfordPATerminated
PED393302-26ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Electromyography11279 Perry HighwayWexfordPATerminated
PED393302-27ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Electroencephalography11279 Perry HighwayWexfordPATerminated
PED393302-28ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Child & Family Counseling11279 Perry HighwayWexfordPATerminated
PED393302-29ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Communication Disorders11279 Perry HighwayWexfordPATerminated
PED393302-30ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Occupational Therapy11279 Perry HighwayWexfordPATerminated
PED393302-31ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Sleep Study Center2619 Wexford-Bayne RoadSewickleyPATerminated
PED393302-32ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Pulmonary Function2559 Wexford-Bayne RoadSewickleyPATerminated
PED393302-33ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Phlebotomy Services2559 Wexford-Bayne RoadSewickleyPATerminated
PED393302-34ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/EKG / ECHO2559 Wexford-Bayne RoadSewickleyPATerminated
PED393302-35ChildPEDCHILDREN'S HOSPITAL OF PITTSBURGH OF UPMCNorth Satellite/MRI2559 Wexford-Bayne RoadSewickleyPATerminated
PED393302-36ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Radiology Diagnostic2559 Wexford-Bayne RoadSewickleyPATerminated
PED393302-37ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Audiology2559 Wexford-Bayne RoadSewickleyPATerminated
PED393302-38ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Surgery Center2599 Wexford-Bayne RoadSewickleyPAActive
PED393302-39ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHNorth Satellite/Physical Therapy11279 Perry HighwayWexfordPATerminated
PED393302-40ChildPEDUPMC CHILDREN'S HOSPITAL OF PITTSBURGHCHP-Pulmonology North - (31315)2599 Wexford-Bayne RoadWexfordPAActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
AddressesBilling AddressUpdateGroup Change RequestHC PHARMACY CENTRAL - PROCUREMENT 3175 E. CARSON ST Pittsburgh, PA 15203UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain PO Box 2058 Portland, OR 972085/15/2025 11:13 AM
AddressesShipping AddressInsertGroup Change Request UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain 3175 E Carson St Pittsburgh, PA 152035/15/2025 11:13 AM
DetailsLast Recertification DateUpdateRecertification 9/6/2024 11:11:03 AM9/6/2024 11:11 AM
DetailsStateUpdate ApprovedActive1/1/2024 12:01 AM
ContactsSigned ByInsertNew Registration Wilfong, Mario Edward CFO UPMC 412692820111/27/2023 4:42 PM
Details340B IDUpdateNew Registration PED393302-4011/27/2023 4:42 PM
DetailsEntity NameUpdateNew RegistrationUPMC CHILDRENS HOSPITAL OF PGHUPMC CHILDREN'S HOSPITAL OF PITTSBURGH11/27/2023 4:42 PM
DetailsEntity SubnameUpdateNew RegistrationCHP-Pulmonology NorthCHP-Pulmonology North - (31315)11/27/2023 4:42 PM
DatesParticipating Approval DateUpdateNew Registration 11/27/2023 4:42:46 PM11/27/2023 4:42 PM
DetailsStateUpdateNew RegistrationPendingApproved11/27/2023 4:42 PM
DatesSigned By DateUpdateNew Registration 11/17/2023 12:39:51 PM11/27/2023 4:42 PM
DatesStart DateUpdateNew Registration 1/1/2024 12:00:00 AM11/27/2023 4:42 PM
AddressesMain AddressInsertNew Registration  2599 Wexford-Bayne Road Wexford, PA 1514310/10/2023 11:55 AM
AddressesBilling AddressInsertNew Registration HC PHARMACY CENTRAL - PROCUREMENT 3175 E. CARSON ST Pittsburgh, PA 1520310/10/2023 11:55 AM
AddressesShipping AddressInsertNew Registration HC PHARMACY CENTRAL - PROCUREMENT 3175 E. CARSON ST Pittsburgh, PA 1520310/10/2023 11:55 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/10/2023 11:55 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 100734799001710/10/2023 11:55 AM
Medicaid BillingMedicaid: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/10/2023 11:55 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 100734799001210/10/2023 11:55 AM
Medicaid BillingMedicaid: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/10/2023 11:55 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 100734799000410/10/2023 11:55 AM
Medicaid BillingMedicaid: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/10/2023 11:55 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 100734799005910/10/2023 11:55 AM
Medicaid BillingMedicaid: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/10/2023 11:55 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 100734799008910/10/2023 11:55 AM
Medicaid BillingMedicaid: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/10/2023 11:55 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 100734799006010/10/2023 11:55 AM
Medicaid BillingMedicaid: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/10/2023 11:55 AM
Medicaid BillingMedicaid: NumberInsertNew Registration 100734799006910/10/2023 11:55 AM
Medicaid BillingMedicaid: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingNPI: NumberInsertNew Registration 116442689610/10/2023 11:55 AM
Medicaid BillingNPI: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingNPI: NumberInsertNew Registration 105347655610/10/2023 11:55 AM
Medicaid BillingNPI: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingNPI: NumberInsertNew Registration 108385196810/10/2023 11:55 AM
Medicaid BillingNPI: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingNPI: NumberInsertNew Registration 161931335010/10/2023 11:55 AM
Medicaid BillingNPI: StateInsertNew Registration PA10/10/2023 11:55 AM
Medicaid BillingNPI: NumberInsertNew Registration 119488948510/10/2023 11:55 AM
Medicaid BillingNPI: StateInsertNew Registration PA10/10/2023 11:55 AM
ContactsAuthorizing OfficialInsertNew Registration Wilfong, Mario Edward CFO UPMC 412692820110/10/2023 11:55 AM
ContactsPrimary ContactInsertNew Registration Pell, Amanda Manager, 340B Program UPMC 814771835410/10/2023 11:55 AM
DetailsAssistance Received From DateInsertNew Registration  10/10/2023 11:55 AM
DetailsAssistance Received To DateInsertNew Registration  10/10/2023 11:55 AM
DetailsLast Recertification DateInsertNew Registration  10/10/2023 11:55 AM
DetailsGrant NumberInsertNew Registration  10/10/2023 11:55 AM
Details340B IDInsertNew Registration  10/10/2023 11:55 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/10/2023 11:55 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/10/2023 11:55 AM
DetailsMedicare Provider NumberInsertNew Registration 39330210/10/2023 11:55 AM
DetailsEntity NameInsertNew Registration UPMC CHILDRENS HOSPITAL OF PGH10/10/2023 11:55 AM
DetailsNOFO NumberInsertNew Registration  10/10/2023 11:55 AM
DetailsProgram CodeInsertNew Registration PED10/10/2023 11:55 AM
DetailsEntity SubnameInsertNew Registration CHP-Pulmonology North10/10/2023 11:55 AM
DatesParticipating Approval DateInsertNew Registration  10/10/2023 11:55 AM
DetailsStateInsertNew Registration Pending10/10/2023 11:55 AM
DatesRegistration DateInsertNew Registration 10/10/2023 11:55:56 AM10/10/2023 11:55 AM
DatesSigned By DateInsertNew Registration  10/10/2023 11:55 AM
DatesStart DateInsertNew Registration  10/10/2023 11:55 AM
TerminationsTermination CommentsInsertNew Registration  10/10/2023 11:55 AM
TerminationsTermination DateInsertNew Registration  10/10/2023 11:55 AM
TerminationsTermination Effective DateInsertNew Registration  10/10/2023 11:55 AM
TerminationsTermination ReasonInsertNew Registration  10/10/2023 11:55 AM