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PARK AVENUE PHARMACY
CH03270AA Keystone Rural Health Center
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Covered Entity Details
Entity Name
Keystone Rural Health Center
Subdivision Name
Keystone Foot and Ankle Center Waynesboro
Type
HRSA-Funded Health Center
340B ID
CH03270AA
Entity Address
1905 Market Square Blvd
Waynesboro, PA 17268-3811
Grant Number
H80CS00076
Participating Start Date
10/1/2019
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
PARK AVENUE PHARMACY
Pharmacy Address
220 PARK AVE
CHAMBERSBURG, PA 17201
Pharmacy Comments
Contract Details
Approval Date
1/16/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOANNE COCHRAN, PRESIDENT AND CEO
(717) 709-7906
Contract Pharmacy Representative
Park Ave Pharmacy
Jenny Hopple, Owner
(717) 264-7312
Signed By Date
1/16/2023
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