340B Drug Pricing Program Database

Name

Mazzoni Center

Subdivision Name

Type

Ryan White Part D

340B ID

RW424852A

Grant Number

H12HA24852

Current Program Status

Terminated

Registration Date

7/5/2016

Participating Start Date

10/1/2016

Participating Approval Date

7/22/2016

Last Recertification Date

2/16/2020

Time Period the Assistance was Received

Termination Date
Termination Reason

4/1/2021
Business decision by the Covered Entity

Authorizing Official

Mazzoni Center
Alecia Manley, Executive Operating Officer
(215) 563-0652

Primary Contact

Mazzoni Center
Valerie Canavin, Compliance Director
(215) 563-0652

Street Address

1348 Bainbridge Street
Philadelphia, PA 19147-1810

Billing Address
Same as Street Address