340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PENNSYLVANIA CVS PHARMACY, L.L.C.
DSH390198 MILLCREEK COMMUNITY HOSPITAL
Print
Covered Entity Details
Entity Name
MILLCREEK COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390198
Entity Address
5515 Peach Street
ERIE, PA 16509
Medicare Provider Number
390198
Participating Start Date
12/28/2020
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
CVS/PHARMACY #11421
1216 W 6TH ST
ERIE, PA 16507-1022
Pharmacy Comments
Contract Details
Approval Date
12/28/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marcus Chase Babiak, Chief Operating Officer
(814) 868-7733
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
12/18/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session