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DSH390185A LEHIGH VALLEY HOSPITAL-HAZLETON (Terminated)
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Main Details
Name
LEHIGH VALLEY HOSPITAL-HAZLETON
Subdivision Name
Healthy Beginnings - HBP - Hometown - 106
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390185A
Medicare Provider Number
390185
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/4/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/31/2019
Last Recertification Date
8/31/2023
Termination Date
Termination Reason
4/1/2024
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Lehigh Valley Health Network
Thomas Marchozzi, Executive Vice President & Chief Financial Officer
(484) 862-3943
Primary Contact
Lehigh Valley Hospital
Paul Mattern, 340B Program Manager
(610) 402-1007
Addresses
Street Address
241 Claremont Ave
Tamaqua, PA 18252
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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