340B Drug Pricing Program Database
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DSH390073B ALTOONA REGIONAL HEALTH SYSTEM (Active)
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Main Details
Name
ALTOONA REGIONAL HEALTH SYSTEM
Subdivision Name
University Pittsburgh Medical Center ALTOONA / MRI
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390073B
Medicare Provider Number
390073
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/30/2018
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
UPMC Altoona
Monica J Klatt, Chief Financial Officer
(814) 889-2223
Primary Contact
UPMC
Stephen Bedell, 340B Manager
(703) 232-5693
Addresses
Street Address
1516 9TH AVE
UPMC ALTOONA STATION MEDICAL CENTER
ALTOONA, PA 16602-2417
Billing Address
UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain
PO Box 2058
Portland, OR 97208
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (7/1/2017) until terminated effective date (1/1/2018), reinstatement date effective (10/01/2018)
07/30/2018
June 2025
June 2025
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