Contract Pharmacy Details

PARK AVENUE PHARMACY
CH03270K KEYSTONE RURAL HEALTH CENTER

Covered Entity Details

Entity Name

KEYSTONE RURAL HEALTH CENTER

Subdivision Name

Keystone Agricultural Worker Program - Franklin Co.

Type

HRSA-Funded Health Center

340B ID

CH03270K

Entity Address

820 5th Ave
Chambersburg, PA 17201-4219

Grant Number

H80CS00076

Participating Start Date

4/1/2007

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

8/17/2010

Contract Begin Date

8/26/2010

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/9/2022
Agreement registered in error

Contacts

Covered Entity Signing Official

JOANNE COCHRAN, PRESIDENT AND CEO
(717) 709-7906

Contract Pharmacy Representative

Signed By Date

8/9/2010

340B Drug Pricing Program Database