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WEIS PHARMACY #198
CH03122J N PENN COMPREHENSIVE HEALTH SVCS
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Covered Entity Details
Entity Name
N PENN COMPREHENSIVE HEALTH SVCS
Subdivision Name
BLOSSBURG LAUREL HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH03122J
Entity Address
6 Riverside Plaza
Blossburg, PA 16912-1137
Grant Number
H80CS00682
Participating Start Date
1/1/2009
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
WEIS PHARMACY #198
Pharmacy Address
11798 ROUTE 6
WELLSBORO, PA 16901
Pharmacy Comments
Contract Details
Approval Date
1/15/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Steven A. Kramer, CEO
(570) 723-0527
Contract Pharmacy Representative
WEIS MARKETS
Rick Seipp, Vice President of Pharmacy
(570) 863-2812
Signed By Date
1/15/2015
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