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DSH390030AN Lehigh Valley Hospital - Schuylkill (Terminated)
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Main Details
Name
Lehigh Valley Hospital - Schuylkill
Subdivision Name
Short Procedure Unit - (62402, 10006046) - Short Procedure Unit
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH390030AN
Medicare Provider Number
390030
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2020
Participating Start Date
7/1/2020
Participating Approval Date
5/13/2020
Last Recertification Date
8/29/2022
Termination Date
Termination Reason
1/1/2023
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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