Contract Pharmacy Details

WALNUT HOME THERAPEUTICS
DSH390329 EINSTEIN MEDICAL CENTER MONTGOMERY

Covered Entity Details

Entity Name

EINSTEIN MEDICAL CENTER MONTGOMERY

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH390329

Entity Address

559 WEST GERMANTOWN PIKE
EAST NORRITON, PA 19403

Medicare Provider Number

390329

Participating Start Date

7/1/2016

Last Recertification Date

8/20/2024

Entity Termination Date

1/1/2025

Pharmacy Details

Pharmacy Name

WALNUT HOME THERAPEUTICS

Pharmacy Address

3500 HORIZON DRIVE
KING OF PRUSSIA, PA 19406

Pharmacy Comments

Contract Details

Approval Date

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

CARRIE FREY, Director of Finance
(215) 612-4313

Contract Pharmacy Representative

Thomas Jefferson University Hospital
Brian G. Swift, Chief Pharmacy Officer
(215) 955-6736

Signed By Date

4/15/2025

340B Drug Pricing Program Database