340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
PENNSYLVANIA CVS PHARMACY, L.L.C.
DSH390180 Crozer Chester Medical Center
Print
Covered Entity Details
Entity Name
Crozer Chester Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390180
Entity Address
One Medical Center Blvd
Upland, PA 19013-3995
Medicare Provider Number
390180
Participating Start Date
4/1/2012
Last Recertification Date
8/11/2015
Entity Termination Date
10/1/2016
Pharmacy Details
Pharmacy Name
PENNSYLVANIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01296
5001 TOWNSHIP LINE ROAD
DREXEL HILL, PA 19026
Pharmacy Comments
Contract Details
Approval Date
12/10/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/9/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Philip J. Ryan, Senior VP & CFO
(610) 338-8228
Contract Pharmacy Representative
Scott Tierney, Senior Director, Payer Relations
(401) 770-2762
Signed By Date
10/12/2012
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