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APPLEBY'S DRUG STORE
CH030220N Broad Top Area Medical Center, Inc., The
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Covered Entity Details
Entity Name
Broad Top Area Medical Center, Inc., The
Subdivision Name
Broad Top Area Medical Center INC
Type
HRSA-Funded Health Center
340B ID
CH030220N
Entity Address
358 Seminary St
Cassville, PA 16623-6203
Grant Number
H80CS00330
Participating Start Date
4/1/2022
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
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