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MOUNTAIN LAUREL COMMUNITY PHARMACY
CHC06642-00 WESTERN MARYLAND HEALTH CARE CORPORATION
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Covered Entity Details
Entity Name
WESTERN MARYLAND HEALTH CARE CORPORATION
Subdivision Name
Mountain Laurel Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC06642-00
Entity Address
1027 Memorial Dr
Oakland, MD 21550-4343
Grant Number
H80CS06642
Participating Start Date
4/1/2013
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MOUNTAIN LAUREL COMMUNITY PHARMACY
Pharmacy Address
1027 MEMORIAL DRIVE
SUITE 100
OAKLAND, MD 21550
Pharmacy Comments
Contract Details
Approval Date
12/17/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Beth Little-Terry, CEO
(301) 533-3300 Ext: 3019
Contract Pharmacy Representative
Cardinal Health
Leslie Stone, Director of Pharmacy
(301) 245-7002
Signed By Date
12/17/2015
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