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SMALL TOWN PHARMACY 2
RWI19403 Family Service of Montgomery County, Pennsylvania
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Covered Entity Details
Entity Name
Family Service of Montgomery County, Pennsylvania
Subdivision Name
Type
Ryan White Part A
340B ID
RWI19403
Entity Address
3125 Ridge Pike
Eagleville, PA 19403
Grant Number
H89HA00013
Participating Start Date
4/1/2015
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SMALL TOWN PHARMACY 2
Pharmacy Address
80 W GERMANTOWN PIKE
NORRISTOWN, PA 19401
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
2/22/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Tim O'Connell, Dir. Special Projects
(610) 630-2111 Ext: 224
Contract Pharmacy Representative
Small Town Pharmacy 2
Christopher Pino, Phamacist/Owner
(610) 279-6575
Signed By Date
1/15/2021
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