340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WEIS PHARMACY #198
CAH391316-02 WELLSBORO
Print
Covered Entity Details
Entity Name
WELLSBORO
Subdivision Name
OFFICE OF INTERAL MEDICINE A DEPT - INTERNAL MEDICINE
Type
Critical Access Hospital
340B ID
CAH391316-02
Entity Address
103 WEST AVE
STE 203
WELLSBORO, PA 16901-1358
Medicare Provider Number
391316
Outpatient Facility Provider Number
Participating Start Date
4/1/2020
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
WEIS PHARMACY #198
Pharmacy Address
11798 ROUTE 6
WELLSBORO, PA 16901
Pharmacy Comments
Contract Details
Approval Date
1/13/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/26/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
Christopher Stockhausen, CFO
(412) 664-2528
Contract Pharmacy Representative
Weis Pharmacy
A Rick Seipp, District Manager
(570) 724-6433
Signed By Date
1/13/2021
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