Covered Entity Details

CH030220 BROAD TOP AREA MEDICAL CENTER (Terminated)

Main Details

Name

BROAD TOP AREA MEDICAL CENTER

Subdivision Name

Type

HRSA-Funded Health Center

Site ID

Admin

340B ID

CH030220

Grant Number

H80CS00330

Additional Details

Current Program Status

Terminated

Registration Date

4/1/2003

Participating Start Date

4/1/2003

Participating Approval Date

12/16/2009

Last Recertification Date

1/28/2020

Termination Date
Termination Reason

10/1/2020
Other

Contacts

Authorizing Official

Broad Top Area Medical Center, Inc.
John Roth, CEO
(814) 635-7351

Primary Contact

Broad Top Medical Center, Inc
Rita Hollibaugh, 340B Coordinator / Patient Access Programs Director
(814) 907-3400 Ext: 2209

Addresses

Street Address

RT 913
BROAD TOP, PA 16621-9001

Billing Address

BROAD TOP AREA MEDICAL CENTER
4133 MEDICAL CENTER DRIVE
BROAD TOP, PA 16621

Comment	Last Updated On
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1 Item 1 to 2 of 2 Page: of 1 Page size:
4/1/14 There has been some confusion about the address of this clinic, the address was changed about 5 years ago by the city or county due to a 911 reassignment, what was in 340B at the time of recert in 2014 was the post-911 reassignment address, and what is in EHB as the grantee of record address was the pre-911 reassignment address, plus the Site ID was wrong since recert in 2013, thus the termination, but on 4/1/14 OPA made the decision to unterminate it but make the address the old one that we're seeing as the organization address on the Form 5B, with site id=ADMIN; 12/16/09 UPDATED ADDR (WAS PO BOX 127 RT 913)	04/01/2014
12/16/09 UPDATED ADDR (WAS PO BOX 127 RT 913)	01/21/2010

340B Drug Pricing Program Database