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ORBY PHARMACY INC
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
ORBY PHARMACY INC
Pharmacy Address
SOUTHERN HUNTINGDON MEDICAL
626 WATER ST STE 3
PO BOX 367
ORBISONIA, PA 17243
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
Orby Pharmacy
Tyler Ruby, Manager
(814) 447-3934
Signed By Date
7/13/2020
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