340B Drug Pricing Program Database
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RRC390001-16 COMMUNITY MEDICAL CENTER (Terminated)
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Main Details
Name
COMMUNITY MEDICAL CENTER
Subdivision Name
Endocrinology W. Olive St. - Endocrinology
Type
Rural Referral Center
Rural
Yes
340B ID
RRC390001-16
Medicare Provider Number
390001
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2023
Participating Start Date
1/1/2024
Participating Approval Date
11/28/2023
Last Recertification Date
Termination Date
Termination Reason
7/1/2024
Business decision by the Covered Entity
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
3 West Olive Street
Suite 220
Scranton, PA 18508
Billing Address
Geisinger Community Medical Center
1800 Mulberry St
Scranton, PA 18510
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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