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CHARTWELL PENNSYLVANIA
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
CHARTWELL PENNSYLVANIA
Pharmacy Address
1001 OAKDALE RD
OAKDALE, PA 15071-1502
Pharmacy Comments
Contract Details
Approval Date
10/7/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
NICHOLAS BARCELLONA, CFO
(412) 692-7331
Contract Pharmacy Representative
UPMC Pinnacle
Kathie Patrick, Manager
(412) 818-7665
Signed By Date
10/7/2016
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