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THE HOMETOWN PHARMACY
CH03406T PRIMARY HEALTH NETWORK, INC.
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Covered Entity Details
Entity Name
PRIMARY HEALTH NETWORK, INC.
Subdivision Name
GREEN STREET PRIMARY CARE B
Type
HRSA-Funded Health Center
340B ID
CH03406T
Entity Address
2000 Green St
Farrell, PA 16121-1364
Grant Number
H80CS00663
Participating Start Date
10/1/2006
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
THE HOMETOWN PHARMACY
Pharmacy Address
7160 WARREN-SHARON RD
BROOKFIELD, OH 44403
Pharmacy Comments
Contract Details
Approval Date
7/11/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/6/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John D. Laeng, CEO
(724) 342-3002 Ext: 215
Contract Pharmacy Representative
Ron McDermott, Sr Vice President
(330) 318-3926
Signed By Date
7/11/2013
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