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PARK AVENUE PHARMACY
CH032700 KEYSTONE RURAL HEALTH CENTER
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Covered Entity Details
Entity Name
KEYSTONE RURAL HEALTH CENTER
Subdivision Name
ADMINISTRATION
Type
HRSA-Funded Health Center
340B ID
CH032700
Entity Address
111 Chambers Hill Drive, Suite 200
CHAMBERSBURG, PA 17201
Grant Number
H80CS00076
Participating Start Date
1/1/2000
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PARK AVENUE PHARMACY
Pharmacy Address
220 PARK AVE
CHAMBERSBURG, PA 17201
Pharmacy Comments
Contract Details
Approval Date
12/5/2011
Contract Begin Date
12/5/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOANNE COCHRAN, PRESIDENT AND CEO
(717) 709-7906
Contract Pharmacy Representative
Park Ave Pharmacy
Jenny Hopple, Owner
(717) 264-7312
Signed By Date
11/18/2011
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