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UPMC MERCY OUTPATIENT PHARMACY
DSH390028 UPMC MERCY
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Covered Entity Details
Entity Name
UPMC MERCY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390028
Entity Address
1400 LOCUST STREET
PITTSBURGH, PA 15219
Medicare Provider Number
390028
Participating Start Date
9/2/2008
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
UPMC MERCY OUTPATIENT PHARMACY
Pharmacy Address
1622 LOCUST ST
PITTSBURGH, PA 15219
Pharmacy Comments
Contract Details
Approval Date
7/3/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jonathan Petrie, CFO UPMC Magee and Mercy
(412) 578-9416
Contract Pharmacy Representative
UPMC
Lisa Rossi, Director, UPMC Retail Pharmacy Network
(412) 438-5049
Signed By Date
7/3/2024
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