340B Drug Pricing Program Database
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DSH390133BW LEHIGH VALLEY (Active)
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Main Details
Name
LEHIGH VALLEY
Subdivision Name
Lehigh Valley Hospital - CRB OR (13403)
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH390133BW
Medicare Provider Number
390133
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/11/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/18/2022
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Lehigh Valley Health Network
Robert Thomas, Sr. Vice President Finance & Chief Accounting Officer
(484) 884-0901
Primary Contact
Lehigh Valley Hospital
Paul Mattern, 340B Program Manager
(610) 402-1007
Addresses
Street Address
2128 Blakeslee BLVD DR East
Lehighton, PA 18235
Billing Address
Lehigh Valley Hospital
2100 Mack Boulevard
Allentown, PA 18103
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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