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ANDREW BROWN'S DRUG STORE
FQHCLA394J Wright Center Medical Group, P.C., The
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Covered Entity Details
Entity Name
Wright Center Medical Group, P.C., The
Subdivision Name
The Wright Center for Community Health Northeast Scranton Intermediate School
Type
Health Center Program Look-Alike
340B ID
FQHCLA394J
Entity Address
721 Adams Ave
Scranton, PA 18510-1603
Grant Number
LALCS33109
Participating Start Date
10/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ANDREW BROWN'S DRUG STORE
Pharmacy Address
5 WASHINGTON AVENUE
SUITE ONE
JERMYN, PA 18433
Pharmacy Comments
Contract Details
Approval Date
9/3/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/6/2020
Pharmacy closed
Contacts
Covered Entity Signing Official
Maria Montoro Edwards, Vice President of Grants & Strategic Initiatives
(570) 343-2383 Ext: 2091
Contract Pharmacy Representative
ANDREW BROWN'S DRUG STORE
MICHAEL BROWN, PRESIDENT
(570) 840-8600
Signed By Date
7/8/2019
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