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PENNSYLVANIA CVS PHARMACY, L.L.C.
DSH390006 GEISINGER MEDICAL CENTER
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Covered Entity Details
Entity Name
GEISINGER MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390006
Entity Address
100 NORTH ACADEMY AVENUE
DANVILLE, PA 17822
Medicare Provider Number
390006
Participating Start Date
4/1/2008
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01590
823 NEW BERWICK HIGHWAY
BLOOMSBURG, PA 17815
Pharmacy Comments
Contract Details
Approval Date
1/18/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas P. Sokola, Chief Administrative Officer
(570) 271-8892
Contract Pharmacy Representative
CVS
Christian Reid, 340B Program Director, CVS Pharmacy
(401) 770-2118
Signed By Date
1/18/2016
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