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DSH390006AT GEISINGER MEDICAL CENTER (Active)
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Main Details
Name
GEISINGER MEDICAL CENTER
Subdivision Name
GEISINGER MEDICAL CENTER / West 2 Med Surg GSACH
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390006AT
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
4200 HOSPITAL RD
G-SACH
COAL TOWNSHIP, PA 17866-9668
Billing Address
Geisinger Medical Center
100 North Academy Ave
Danville, PA 17822
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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