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DEPIETRO'S PHARMACY
CHC00074-01 Scranton Primary Health Care Center, Inc.
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Covered Entity Details
Entity Name
Scranton Primary Health Care Center, Inc.
Subdivision Name
Alder Street
Type
HRSA-Funded Health Center
340B ID
CHC00074-01
Entity Address
425 Alder Street
Scranton, PA 18505-4116
Grant Number
H80CS00074
Participating Start Date
1/1/2018
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
DEPIETRO'S PHARMACY
Pharmacy Address
617 3RD ST
DUNMORE, PA 18512-2849
Pharmacy Comments
Contract Details
Approval Date
10/11/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph H. Hollander, Chief Executive Officer
(570) 344-3517
Contract Pharmacy Representative
DePietro's Pharmacy
Thomas DePietro, Owner
(570) 209-7440
Signed By Date
10/11/2021
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