340B Drug Pricing Program Database
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DSH390133CP LEHIGH VALLEY (Active)
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Main Details
Name
LEHIGH VALLEY
Subdivision Name
Lehigh Valley Hospital - HAS RHEUM (02696) - Rheumatology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390133CP
Medicare Provider Number
390133
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/12/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/21/2024
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Lehigh Valley Health Network
Robert Thomas, Sr. Vice President Finance & Chief Accounting Officer
(484) 884-0901
Primary Contact
Lehigh Valley Hospital
Paul Mattern, 340B Program Manager
(610) 402-1007
Addresses
Street Address
798 Hausman Road, 3rd Floor, Suite 300
Allentown, PA 18104
Billing Address
Lehigh Valley Hospital
2100 Mack Boulevard
Allentown, PA 18103
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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