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BEDFORD ROAD PHARMACY, INC. DBA
CHC06642-00 WESTERN MARYLAND HEALTH CARE CORPORATION
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Covered Entity Details
Entity Name
WESTERN MARYLAND HEALTH CARE CORPORATION
Subdivision Name
Mountain Laurel Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC06642-00
Entity Address
1027 Memorial Dr
Oakland, MD 21550-4343
Grant Number
H80CS06642
Participating Start Date
4/1/2013
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
10/23/2019
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
Jeremy Wilson, CFO
(301) 533-3300 Ext: 3018
Contract Pharmacy Representative
Medicine Shoppe
Randy Trumbule, Director of Retail Pharmacy
(301) 895-5177
Signed By Date
10/23/2019
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