Contract Pharmacy Details

EDGEWOOD PHARMACY
CH03406A PRIMARY HEALTH NETWORK, INC.

Covered Entity Details

Entity Name

PRIMARY HEALTH NETWORK, INC.

Subdivision Name

FARRELL HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH03406A

Entity Address

602 Roemer Blvd
Farrell, PA 16121-1902

Grant Number

H80CS00663

Participating Start Date

1/1/2003

Last Recertification Date

2/26/2018

Entity Termination Date

4/1/2019

Pharmacy Details

Pharmacy Name

EDGEWOOD PHARMACY

Pharmacy Address

225 EDGEWOOD DRIVE
SUITE 102
TRANSFER, PA 16154

Pharmacy Comments

Contract Details

Approval Date

4/20/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Drew C. Pierce, CEO
(724) 342-3002 Ext: 1506

Contract Pharmacy Representative

Bretton C. Wallberg, Owner
(724) 373-8533

Signed By Date

4/20/2017