Contract Pharmacy Details

MEDICINE SHOPPE 1865
FP171021 HAMILTON HEALTH CENTER INC

Covered Entity Details

Entity Name

HAMILTON HEALTH CENTER INC

Subdivision Name

Type

Family Planning (Title X only)

340B ID

FP171021

Entity Address

110 South 17th Street
HARRISBURG, PA 17104

Grant Number

FPHPA030282

Participating Start Date

4/1/2006

Last Recertification Date

4/26/2018

Entity Termination Date

7/1/2019

Pharmacy Details

Pharmacy Name

MEDICINE SHOPPE 1865

Pharmacy Address

110 S. 17TH STREET
HARRISBURG, PA 17104

Pharmacy Comments

7/3/2013: OPA request to add DEA number.

Contract Details

Approval Date

4/15/2006

Contract Begin Date

4/15/2006

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2019
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

3/20/2006

340B Drug Pricing Program Database