340B Drug Pricing Program Database
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DSH390001 COMMUNITY MEDICAL CENTER (Terminated)
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Main Details
Name
COMMUNITY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390001
Medicare Provider Number
390001
Additional Details
Current Program Status
Terminated
Registration Date
3/11/2022
Participating Start Date
4/1/2022
Participating Approval Date
3/14/2022
Last Recertification Date
9/3/2023
Termination Date
Termination Reason
1/1/2024
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
1800 MULBERRY STREET
SCRANTON, PA 18510
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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