340B Drug Pricing Program Database
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DSH390063E UPMC HAMOT (Active)
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Main Details
Name
UPMC HAMOT
Subdivision Name
Hamot RRC Injection Suite (33352)
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390063E
Medicare Provider Number
390063
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/26/2020
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
UPMC Hamot
Brad N Dinger, CFO
(814) 877-3739
Primary Contact
UPMC
Amanda Pell, Manager, 340B Program
(814) 771-8354
Addresses
Street Address
2500 West 12th Street
Erie, PA 16505
Billing Address
UPMC Presbyterian Shadyside DBA UPMC Pharmacy Supply Chain
PO Box 2058
Portland, OR 97208
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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