340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BEDFORD ROAD PHARMACY, INC. DBA
CHC06642-01 WESTERN MARYLAND HEALTH CARE CORPORATION
Print
Covered Entity Details
Entity Name
WESTERN MARYLAND HEALTH CARE CORPORATION
Subdivision Name
Mountain Laurel Medical Center Grantsville
Type
HRSA-Funded Health Center
340B ID
CHC06642-01
Entity Address
104 PARKVIEW DR
GRANTSVILLE, MD 21536-1086
Grant Number
H80CS06642
Participating Start Date
7/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
BEDFORD ROAD PHARMACY, INC. DBA
Pharmacy Address
THE MEDICINE SHOPPE OF GEORGES CREEK
19 MAIN ST
LONACONING, MD 21539-1122
Pharmacy Comments
Contract Details
Approval Date
10/21/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/27/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Charles Lee Wilt, CEO
(301) 533-3300 Ext: 3056
Contract Pharmacy Representative
Medicine Shoppe
Randy Trumbule, Director of Retail Pharmacy
(301) 895-5177
Signed By Date
10/21/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session