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RRC390079-00 ROBERT PACKER HOSPITAL (Active)
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Main Details
Name
ROBERT PACKER HOSPITAL
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC390079-00
Medicare Provider Number
390079
Additional Details
Current Program Status
Active
Registration Date
10/10/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/20/2017
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
The Guthrie Clinic
Matthew David Denniston, VP, Pharmacy Services
(570) 887-6626
Primary Contact
Robert Packer Hospital
Heather Lee Lodge, Pharmacy Services Financial Analyst
(570) 887-4375
Addresses
Street Address
ONE GUTHRIE SQUARE
SAYRE, PA 18840
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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