340B Drug Pricing Program Database
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DSH390090F West Penn Hospital (Active)
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Main Details
Name
West Penn Hospital
Subdivision Name
WEST PENN HOSPITAL OUTPATIENT SERVICES AT MELLON PAVILION
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390090F
Medicare Provider Number
390090
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
11/24/2009
Participating Start Date
1/1/2010
Participating Approval Date
11/30/2009
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
West Penn Hospital
Brian Johnson, President & CEO
(412) 578-1176
Primary Contact
West Penn Hospital
Robert W Simpson, Director, Pharmacy
(412) 266-8693
Addresses
Street Address
4815 LIBERTY AVENUE
SUITE 340
PITTSBURGH, PA 15224-2156
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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4/11/12 UPDATED MAIN ADD SUITE # (WAS SUITE 340); 11/19/10 UPDATED ADDR (WAS 4727 FRIENDSHIP)SUBDIVISION NAME(WAS...SERVICES AT CERCONE)02/17/11 UPDATED ADDR.(WAS 4800 FRIENDSHIP AVENUE, SUITE 340)
04/11/2012
11/19/10 UPDATED ADDR (WAS 4727 FRIENDSHIP)SUBDIVISION NAME(WAS...SERVICES AT CERCONE)02/17/11 UPDATED ADDR.(WAS 4800 FRIENDSHIP AVENUE, SUITE 340)
02/17/2011
April 2025
April 2025
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