Contract Pharmacy Details

PENNSYLVANIA CVS PHARMACY, L.L.C.
HV032130 LEHIGH VALLEY HOSPITAL

Covered Entity Details

Entity Name

LEHIGH VALLEY HOSPITAL

Subdivision Name

Type

Ryan White Part C

340B ID

HV032130

Entity Address

1627 Chew Street, Third Floor
Allentown, PA 18102

Grant Number

6 H76HA00078-33-04

Participating Start Date

4/1/1996

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

PENNSYLVANIA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 04234
5801 W. TILGHMAN ST.
ALLENTOWN, PA 18104

Pharmacy Comments

Contract Details

Approval Date

1/14/2021

Contract Begin Date

4/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Thomas Marchozzi, Executive Vice President & Chief Financial Officer
(484) 862-3943

Contract Pharmacy Representative

Lehigh Valley Health Network
Claude Laurence Parnell, 340B Program Manager
(610) 402-5522

Signed By Date

1/14/2021

340B Drug Pricing Program Database