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BLOSS PHARMACY, INC
CH03122A N PENN COMPREHENSIVE HEALTH SVCS
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Covered Entity Details
Entity Name
N PENN COMPREHENSIVE HEALTH SVCS
Subdivision Name
WELLSBORO LAUREL HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH03122A
Entity Address
7 Water Street
Wellsboro, PA 16901-1358
Grant Number
H80CS00682
Participating Start Date
1/1/2009
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
BLOSS PHARMACY, INC
Pharmacy Address
2 RIVERSIDE PLZ
BLOSSBURG, PA 16912-1137
Pharmacy Comments
Contract Details
Approval Date
6/20/2012
Contract Begin Date
6/20/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/10/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
RONALD J. BUTLER, PRESIDENT AND CEO
(570) 723-0503
Contract Pharmacy Representative
BLOSS PHARMACY
Patrick Bauman, President
(570) 638-2820
Signed By Date
5/25/2012
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