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APPLEBY'S DRUG STORE
CH030220F BROAD TOP AREA MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
BROAD TOP AREA MEDICAL CENTER, INC.
Subdivision Name
BROAD TOP AREA MEDICAL CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH030220F
Entity Address
4133 MEDICAL CENTER DRIVE
BROAD TOP, PA 16621-9001
Grant Number
H80CS00330
Participating Start Date
4/1/2017
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
APPLEBY'S DRUG STORE
Pharmacy Address
133 E. SHIRLEY ST.
MOUNT UNION, PA 17066
Pharmacy Comments
Contract Details
Approval Date
7/13/2020
Contract Begin Date
7/13/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Roth, CEO
(814) 635-7351
Contract Pharmacy Representative
Appleby's Drug Store
Troy Parsons, owner
(814) 542-4412
Signed By Date
7/13/2020
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