340B Drug Pricing Program Database
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DSH390133J LEHIGH VALLEY (Terminated)
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Main Details
Name
LEHIGH VALLEY
Subdivision Name
Lehigh Valley Hospital - 17 CDC (02127)
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390133J
Medicare Provider Number
390133
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/6/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/28/2022
Last Recertification Date
8/29/2024
Termination Date
Termination Reason
1/1/2025
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Lehigh Valley Health Network
Thomas Marchozzi, Executive Vice President & Chief Financial Officer
(484) 862-3943
Primary Contact
Lehigh Valley Hospital
Paul Mattern, 340B Program Manager
(610) 402-1007
Addresses
Street Address
1627 West Chew Street, 1st Floor
Allentown, PA 18102
Billing Address
Lehigh Valley Hospital
2100 Mack Boulevard
Allentown, PA 18103
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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