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RXD MEDICATION SERVICES
DSH390142 ALBERT EINSTEIN MEDICAL CENTER
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Covered Entity Details
Entity Name
ALBERT EINSTEIN MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390142
Entity Address
5501 OLD YORK ROAD
PHILADELPHIA, PA 19141
Medicare Provider Number
390142
Participating Start Date
1/1/2005
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
RXD MEDICATION SERVICES
Pharmacy Address
1335 W TABOR RD
PHILADELPHIA, PA 19141
Pharmacy Comments
Contract Details
Approval Date
1/10/2023
Contract Begin Date
1/30/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Walter Wyatt, VP-Finance
(215) 254-3254
Contract Pharmacy Representative
RXD Medication Services
Chuck Tallam, Chief Executive Officer
(215) 927-6700
Signed By Date
1/10/2023
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