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PERIGON PHARMACY 360, LLC
CH0318410 Squirrel Hill Health Center
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Covered Entity Details
Entity Name
Squirrel Hill Health Center
Subdivision Name
Squirrel Hill Health Center
Type
HRSA-Funded Health Center
340B ID
CH0318410
Entity Address
4516 Browns Hill Rd
Pittsburgh, PA 15217-2917
Grant Number
H80CS06643
Participating Start Date
7/1/2006
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
PERIGON PHARMACY 360, LLC
Pharmacy Address
1120 STEVENSON MILL RD STE 200
CORAOPOLIS, PA 15108
Pharmacy Comments
Contract Details
Approval Date
4/15/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
SUSAN FRIEDBERG KALSON, CEO
(412) 904-5283
Contract Pharmacy Representative
Valeda Rx, LLC
Chris Antypas, President
(412) 498-9338
Signed By Date
4/15/2021
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