340B Drug Pricing Program Database
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DSH390063C UPMC HAMOT (Active)
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Main Details
Name
UPMC HAMOT
Subdivision Name
UPMC HAMOT - Hamot NICU Clinic (22001)
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390063C
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
118 EAST 2ND STREET
MAGEE-WOMENS, UPMC HAMOT
ERIE, PA 16507-1502
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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