340B Drug Pricing Program Database
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DSH390006AG GEISINGER MEDICAL CENTER (Active)
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Main Details
Name
GEISINGER MEDICAL CENTER
Subdivision Name
Hematol Oncol ACC Selinsgrove
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390006AG
Medicare Provider Number
390006
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/3/2017
Participating Start Date
4/1/2017
Participating Approval Date
1/9/2017
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Geisinger Health
Michael Anthony Evans, VP Pharmacy CPO
(570) 271-6192
Primary Contact
Geisinger Health
Lola Travelpiece, 340B Program Manager
(570) 214-1035
Addresses
Street Address
1575 N Old Trail
Selinsgrove, PA 17870
Billing Address
Geisinger Medical Center
100 North Acadmey Ave
Danville, PA 17822
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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