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THE LANE DRUG COMPANY
CAH391314-00 TITUSVILLE AREA HOSPITAL
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Covered Entity Details
Entity Name
TITUSVILLE AREA HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH391314-00
Entity Address
406 WEST OAK STREET
TITUSVILLE, PA 16354
Medicare Provider Number
391314
Participating Start Date
7/1/2015
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
THE LANE DRUG COMPANY
Pharmacy Address
RITE AID #2380
975 MARKET STREET
MEADVILLE, PA 16335
Pharmacy Comments
Contract Details
Approval Date
7/21/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jill A Neely, CFO
(814) 827-8923
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
7/21/2021
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