340B Drug Pricing Program Database
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RRC390001-08 COMMUNITY MEDICAL CENTER (Terminated)
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Main Details
Name
COMMUNITY MEDICAL CENTER
Subdivision Name
GEISINGER COMMUNITY MEDICAL CENTER - ULTRASOUND VIEWMONT
Type
Rural Referral Center
Rural
Yes
340B ID
RRC390001-08
Medicare Provider Number
390001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/4/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/16/2019
Last Recertification Date
9/1/2021
Termination Date
Termination Reason
4/1/2022
Change of covered entity type
Contacts
Authorizing Official
Geisinger Wyoming Valley Medical Center
Ron Beer, Chief Admiistrative Officer
(570) 808-5380
Primary Contact
Geisinger Health
Lola Travelpiece, 340B Program Manager
(570) 214-1035
Addresses
Street Address
435 SCRANTON CARBONDALE HIGHWAY
SCRANTON, PA 18508-1115
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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