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DSH390030AG Lehigh Valley Hospital - Schuylkill (Terminated)
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Main Details
Name
Lehigh Valley Hospital - Schuylkill
Subdivision Name
Lehigh Valley Hospital Schuylkill - East Norwegian Street - Outpt Surgery Oper Room - Outpatient Surgery
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390030AG
Medicare Provider Number
390030
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2019
Participating Start Date
1/1/2020
Participating Approval Date
11/14/2019
Last Recertification Date
9/8/2020
Termination Date
Termination Reason
7/1/2021
Other
Contacts
Authorizing Official
Lehigh Valley Health Network
Stephen Patrick Molitoris, Vice President
(484) 884-0974
Primary Contact
Lehigh Valley Health Network
Claude Laurence Parnell, 340B Program Manager
(610) 402-5522
Addresses
Street Address
700 East Norwegian Street
Pottsville, PA 17901
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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