Contract Pharmacy Details

AHN PHARMACY
DSH390090 West Penn Hospital

Covered Entity Details

Entity Name

West Penn Hospital

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH390090

Entity Address

4800 FRIENDSHIP AVE
PITTSBURGH, PA 15224-1722

Medicare Provider Number

390090

Participating Start Date

10/20/2005

Last Recertification Date

8/22/2024

Pharmacy Details

Pharmacy Name

AHN PHARMACY

Pharmacy Address

12311 PERRY HWY
SUITE F
WEXFORD, PA 15090-8344

Pharmacy Comments

Contract Details

Approval Date

10/24/2014

Contract Begin Date

1/1/2015

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Duke Rupert, CEO and President
(412) 578-1176

Contract Pharmacy Representative

West Penn Hospital
Jennifer Davis, Director
(412) 578-4050

Signed By Date

10/24/2014

340B Drug Pricing Program Database