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MACDONALD'S PHARMACY
HV00668 KEYSTONE HIV PROGRAM
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Covered Entity Details
Entity Name
KEYSTONE HIV PROGRAM
Subdivision Name
Type
Ryan White Part C
340B ID
HV00668
Entity Address
111 Chambers Hill Drive, Suite 102
Chambersburg, PA 17201
Grant Number
H76HA00668
Participating Start Date
1/1/2010
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
MACDONALD'S PHARMACY
Pharmacy Address
105 SOUTH 3RD ST
MCCONNELLSBURG, PA 17233
Pharmacy Comments
Contract Details
Approval Date
12/5/2011
Contract Begin Date
12/5/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/10/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JOANNE COCHRAN, PRESIDENT AND CEO
(717) 709-7906
Contract Pharmacy Representative
Ben Stonesifer, Owner
(717) 485-3622
Signed By Date
11/18/2011
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