340B Drug Pricing Program Database
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DSH390270K GEISINGER WYOMING VALLEY MED CTR (Active)
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Main Details
Name
GEISINGER WYOMING VALLEY MED CTR
Subdivision Name
GEISINGER WYOMING VALLEY MEDICAL CE / Ophthalmology Amb Care Fac
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390270K
Medicare Provider Number
390270
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/3/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/28/2017
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Geisinger Wyoming Valley Medical Center
Ron Beer, Chief Admiistrative Officer
(570) 808-5380
Primary Contact
Geisinger Health
Lola Travelpiece, 340B Program Manager
(570) 214-1035
Addresses
Street Address
675 BALTIMORE DR.
WILKES BARRE, PA 18702-7900
Billing Address
Geisinger Wyoming Valley Medical Center
1000 East Mountain Blvd
Wilkes Barre, PA 18711
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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