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KLINGENSMITH'S DRUG STORE
RRC390163-00 Armstrong County Memorial Hospital
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Covered Entity Details
Entity Name
Armstrong County Memorial Hospital
Subdivision Name
Type
Rural Referral Center
340B ID
RRC390163-00
Entity Address
One Nolte Drive
Kittanning, PA 16201
Medicare Provider Number
390163
Participating Start Date
4/1/2012
Last Recertification Date
8/24/2020
Entity Termination Date
10/1/2021
Pharmacy Details
Pharmacy Name
KLINGENSMITH'S DRUG STORE
Pharmacy Address
313 FORD ST
PO BOX 151
FORD CITY, PA 16226-1268
Pharmacy Comments
Contract Details
Approval Date
6/29/2020
Contract Begin Date
6/29/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Matthew F Kociola, Chief Financial Officer
(724) 543-8618
Contract Pharmacy Representative
Klingensmith's Drug Store
Alicia Wolfe, CFO
(724) 763-4024
Signed By Date
6/29/2020
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