340B Drug Pricing Program Database
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DSH390185D LEHIGH VALLEY HOSPITAL-HAZLETON (Active)
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Main Details
Name
LEHIGH VALLEY HOSPITAL-HAZLETON
Subdivision Name
MRI - HWC MRI - 605
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390185D
Medicare Provider Number
390185
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/8/2021
Participating Start Date
4/1/2021
Participating Approval Date
2/12/2021
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Lehigh Valley Health Network
Robert Thomas, Sr. Vice President Finance & Chief Accounting Officer
(484) 884-0901
Primary Contact
Lehigh Valley Hospital
Paul Mattern, 340B Program Manager
(610) 402-1007
Addresses
Street Address
50 Moisey Drive
Hazleton, PA 18201
Billing Address
Lehigh Valley Hospital - Hazleton
700 East Broad Street
Hazleton, PA 18201
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2019, terminated 4/1/2020. Reinstated 4/1/2021.
02/10/2021
June 2025
June 2025
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