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COORDINATED CARE NETWORK PHARMACY
FP18201 MFHS Hazleton Center
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Covered Entity Details
Entity Name
MFHS Hazleton Center
Subdivision Name
Type
Family Planning (Title X only)
340B ID
FP18201
Entity Address
10 WEST CHESTNUT STREET
Suite 6
HAZLETON, PA 18201
Grant Number
FPHPA006505
Participating Start Date
4/1/2010
Last Recertification Date
5/14/2024
Pharmacy Details
Pharmacy Name
COORDINATED CARE NETWORK PHARMACY
Pharmacy Address
249 S 13TH ST
PHILADELPHIA, PA 19107
Pharmacy Comments
Contract Details
Approval Date
7/7/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Maria Montoro Edwards, President & CEO
(570) 823-7000
Contract Pharmacy Representative
Coordinated Care Network
Thomas J Pollack, President/CEO
(412) 349-6300
Signed By Date
7/7/2021
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