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THE MEDICINE SHOPPE
CHC24159-00 River Valley Health
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Covered Entity Details
Entity Name
River Valley Health
Subdivision Name
River Valley Health - Williamsport Medical and Dental
Type
HRSA-Funded Health Center
340B ID
CHC24159-00
Entity Address
471 Hepburn St
Williamsport, PA 17701-6122
Grant Number
H80CS24159
Participating Start Date
4/1/2013
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
THE MEDICINE SHOPPE
Pharmacy Address
507 HEPBURN ST
WILLIAMSPORT, PA 17701
Pharmacy Comments
Contract Details
Approval Date
4/1/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/6/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ellen Krajewski, President & CEO
(570) 567-5412
Contract Pharmacy Representative
Steve Kaminski, Owner/Pharmacist
(570) 323-7733
Signed By Date
4/1/2013
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