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GIANT PHARMACY #6043
FQHCLA410 Star Community Health, Inc.
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Covered Entity Details
Entity Name
Star Community Health, Inc.
Subdivision Name
Star Community Health Administration
Type
Health Center Program Look-Alike
340B ID
FQHCLA410
Entity Address
520 E Broad St Ste 108
Bethlehem, PA 18018-6330
Grant Number
LALCS33897
Participating Start Date
10/1/2020
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
GIANT PHARMACY #6043
Pharmacy Address
1880 LEITHSVILLE ROAD
HELLERTOWN, PA 18055
Pharmacy Comments
Contract Details
Approval Date
10/4/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matthew James, CFO
(484) 658-1887
Contract Pharmacy Representative
The Giant Company
Nick Koch, Regional Pharmacy Manager
(484) 655-0805
Signed By Date
10/4/2022
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