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GIANT EAGLE PHARMACY #0014
PED393302-00 UPMC CHILDREN'S HOSPITAL OF PITTSBURGH
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Covered Entity Details
Entity Name
UPMC CHILDREN'S HOSPITAL OF PITTSBURGH
Subdivision Name
Type
Children's Hospital
340B ID
PED393302-00
Entity Address
4401 PENN AVENUE
PITTSBURGH, PA 15224
Medicare Provider Number
393302
Participating Start Date
1/1/2010
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
GIANT EAGLE PHARMACY #0014
Pharmacy Address
7000 OXFORD DRIVE
BETHEL PARK, PA 15102
Pharmacy Comments
Contract Details
Approval Date
8/22/2012
Contract Begin Date
8/22/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/19/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Laurel Ragland, CFO
(412) 692-6242
Contract Pharmacy Representative
Debra Krasnow, Director of Managed Care
(412) 968-1550
Signed By Date
7/26/2012
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