340B Drug Pricing Program Database
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DSH390113H Meadville Medical Center (Active)
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Main Details
Name
Meadville Medical Center
Subdivision Name
Clinic for Specialty Pain Services
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390113H
Medicare Provider Number
390113
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/6/2016
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Meadville Medical Center
Ellie Jo Amory, 340B Program Administrator
(814) 333-5669
Primary Contact
Meadville Medical Center
Sandra J. Clark, 340B Coordinator
(814) 373-2244
Addresses
Street Address
1034 GROVE STREET
MEADVILLE, PA 16335
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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