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PENNSYLVANIA CVS PHARMACY, L.L.C.
DSH390041 UNIONTOWN HOSPITAL
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Covered Entity Details
Entity Name
UNIONTOWN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390041
Entity Address
500 WEST BERKELEY STREET
UNIONTOWN, PA 15401
Medicare Provider Number
390041
Participating Start Date
4/1/2005
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04077
975 ROSTRAVER RD.
BELLE VERNON, PA 15012
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Barbara A. Weiss, Executive Director, Finance/CFO
(724) 430-5222
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2021
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