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HILLMAN CENTER PHARMACY
DSH390028 UPMC MERCY
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Covered Entity Details
Entity Name
UPMC MERCY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390028
Entity Address
1400 LOCUST STREET
PITTSBURGH, PA 15219
Medicare Provider Number
390028
Participating Start Date
9/2/2008
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
HILLMAN CENTER PHARMACY
Pharmacy Address
5115 CENTRE AVE RM AG30.1
PITTSBURGH, PA 15232
Pharmacy Comments
Contract Details
Approval Date
7/12/2011
Contract Begin Date
7/15/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
6/16/2011
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