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GEISINGER MAIL ORDER PHARMACY
HV46012 Geisinger Clinic
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Covered Entity Details
Entity Name
Geisinger Clinic
Subdivision Name
Geisinger Clinic RW Part C
Type
Ryan White Part C
340B ID
HV46012
Entity Address
100 North Academy Ave
Danville, PA 17822
Grant Number
H76HA46012-02-00
Participating Start Date
1/1/2024
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
GEISINGER MAIL ORDER PHARMACY
Pharmacy Address
210 INDUSTRIAL PARK ROAD
ELYSBURG, PA 17824-9770
Pharmacy Comments
Contract Details
Approval Date
4/15/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michael Anthony Evans, VP Pharmacy CPO
(570) 271-6192
Contract Pharmacy Representative
Geisinger
Jenny D Plummer, Director Retail and Mail Order Pharmacy
(814) 231-4571
Signed By Date
4/15/2024
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