340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MARIENVILLE PHARMACY
CAH391312-00 BROOKVILLE HOSPITAL
Print
Covered Entity Details
Entity Name
BROOKVILLE HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH391312-00
Entity Address
100 HOSPITAL ROAD
BROOKVILLE, PA 15825
Medicare Provider Number
391312
Participating Start Date
1/1/2011
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
MARIENVILLE PHARMACY
Pharmacy Address
120 CHERRY ST
PO BOX 434
MARIENVILLE, PA 16239
Pharmacy Comments
Contract Details
Approval Date
4/10/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JULIANNE PEER, President
(814) 849-1461
Contract Pharmacy Representative
Marienville Pharmacy
Jennifer Hawthorn, Pharmacist
(814) 927-8700
Signed By Date
4/10/2014
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session