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GIANT EAGLE PHARMACY #0069
CH03044AD Primary Care Health Services Inc
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Covered Entity Details
Entity Name
Primary Care Health Services Inc
Subdivision Name
PRIMARY CARE HEALTH SERVICES, INC. Alma Illery Medical Center
Type
HRSA-Funded Health Center
340B ID
CH03044AD
Entity Address
7227 Hamilton Ave
Pittsburgh, PA 15208
Grant Number
H80CS00714
Participating Start Date
1/2/2020
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
GIANT EAGLE PHARMACY #0069
Pharmacy Address
9001 FRANKSTOWN RD
PITTSBURGH, PA 15235
Pharmacy Comments
Contract Details
Approval Date
1/2/2020
Contract Begin Date
1/2/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
jerome gloster, CEO
(412) 244-4700 Ext: 4980
Contract Pharmacy Representative
Giant Eagle, Inc.
Mike Bianco, Senior Pharmacy Manager
(412) 967-3718
Signed By Date
1/2/2020
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