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ST MARY'S PHARMACY INC
CAH391315-00 Elk Regional Health Center
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Covered Entity Details
Entity Name
Elk Regional Health Center
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH391315-00
Entity Address
763 Johnsonburg RD
St. Marys, PA 15857
Medicare Provider Number
391315
Participating Start Date
1/1/2017
Last Recertification Date
8/14/2023
Pharmacy Details
Pharmacy Name
ST MARY'S PHARMACY INC
Pharmacy Address
4 RAILROAD ST
SAINT MARYS, PA 15857
Pharmacy Comments
Contract Details
Approval Date
1/12/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laurie MacDonald, Chief Financial Officer
(814) 788-8743
Contract Pharmacy Representative
Penn Highlands Healthcare
Andrew Kurtz, System Director - Retail Pharmacy Services
(814) 375-6553
Signed By Date
1/12/2022
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