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SCH390048-07 GEISINGER LEWISTOWN HOSPITAL (Terminated)
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Main Details
Name
GEISINGER LEWISTOWN HOSPITAL
Subdivision Name
Geisinger Lewistown Hospital - Gastro Electric Ave
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH390048-07
Medicare Provider Number
390048
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/1/2022
Participating Start Date
10/1/2022
Participating Approval Date
7/6/2022
Last Recertification Date
8/16/2024
Termination Date
Termination Reason
1/1/2025
Change of covered entity type
Contacts
Authorizing Official
Geisinger Health
Michael Anthony Evans, VP Pharmacy CPO
(570) 271-6192
Primary Contact
Geisinger Health
Lola Travelpiece, 340B Program Manager
(570) 214-1035
Addresses
Street Address
310 Electric Ave
Suite 100
Lewistown, PA 17044
Billing Address
Geisinger Lewistown Hospital
400 Highland Ave
Lewistown, PA 17044
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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