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GIANT EAGLE PHARMACY #0098
DSH390184 Highlands Hospital
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Covered Entity Details
Entity Name
Highlands Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390184
Entity Address
401 East Murphy Ave.
Connellsville, PA 15425
Medicare Provider Number
390184
Participating Start Date
7/1/2014
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
GIANT EAGLE PHARMACY #0098
Pharmacy Address
581 PITTSBURGH RD
UNIONTOWN, PA 15401
Pharmacy Comments
Contract Details
Approval Date
1/4/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/29/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
John S. Andursky, Chief Executive Officer
(724) 626-2359
Contract Pharmacy Representative
Giant Eagle, Inc.
Mike Bianco, Senior Pharmacy Manager
(412) 967-3718
Signed By Date
1/4/2017
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