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BUCHANAN BROTHERS PHARMACY
CAH391313-00 CHARLES COLE MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
CHARLES COLE MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH391313-00
Entity Address
1001 EAST 2ND STREET
COUDERSPORT, PA 16915
Medicare Provider Number
391313
Participating Start Date
8/25/2010
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
BUCHANAN BROTHERS PHARMACY
Pharmacy Address
206 W MAIN ST
ELKLAND, PA 16920
Pharmacy Comments
Contract Details
Approval Date
10/20/2011
Contract Begin Date
2/1/2011
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
EDWARD C PITCHFORD, PRESIDENT & CEO
(814) 260-5216
Contract Pharmacy Representative
JOSEPH N. MARZO, PRESIDENT
(814) 274-8660
Signed By Date
1/18/2011
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