Contract Pharmacy Details

APPLEBY'S DRUG STORE
CH030220E BROAD TOP AREA MEDICAL CENTER, INC.

Covered Entity Details

Entity Name

BROAD TOP AREA MEDICAL CENTER, INC.

Subdivision Name

Broad Top Area Medical Center Family Care Center

Type

HRSA-Funded Health Center

340B ID

CH030220E

Entity Address

835 Washington Street
Huntingdon, PA 16652-1725

Grant Number

H80CS00330

Participating Start Date

4/1/2017

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

APPLEBY'S DRUG STORE

Pharmacy Address

133 E. SHIRLEY ST.
MOUNT UNION, PA 17066

Pharmacy Comments

Contract Details

Approval Date

7/14/2024

Contract Begin Date

10/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

John Roth, CEO
(814) 635-7351

Contract Pharmacy Representative

Appleby's Drug Store
Troy Parsons, owner
(814) 542-4412

Signed By Date

7/14/2024

340B Drug Pricing Program Database