340B Drug Pricing Program Database
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DSH390256AT PENN STATE - MILTON S. HERSHEY MEDICAL CENTER (Terminated)
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Main Details
Name
PENN STATE - MILTON S. HERSHEY MEDICAL CENTER
Subdivision Name
Penn State Hershey Medical Group Nyes Rd. / Diagnostic Imaging
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390256AT
Medicare Provider Number
390256
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/1/2017
Last Recertification Date
8/29/2019
Termination Date
Termination Reason
4/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
Milton S. Hershey Medical Center
Eric Strucko, Interim Chief Financial Officer
(717) 531-6122
Primary Contact
Milton S Hershey Medical Center
Vince Lacroce, Administrative Director of Pharmacy
(717) 531-8972
Addresses
Street Address
121 Nyes Rd.
Suite B
Harrisburg, PA 17112
Billing Address
Penn State Milton S. Hershey Medical Center
500 University Dr
Hershey, PA 17033
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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