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MACDONALD'S PHARMACY
CAH391303-00 FULTON COUNTY MEDICAL CENTER
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Covered Entity Details
Entity Name
FULTON COUNTY MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH391303-00
Entity Address
214 PEACH ORCHARD ROAD
MCCONNELLSBURG, PA 17233
Medicare Provider Number
391303
Participating Start Date
4/1/2015
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
MACDONALD'S PHARMACY
Pharmacy Address
105 SOUTH 3RD ST
MCCONNELLSBURG, PA 17233
Pharmacy Comments
Contract Details
Approval Date
7/8/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/14/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Deborah A Shughart, CFO
(717) 485-6109
Contract Pharmacy Representative
Ben Stonesifer, Owner
(717) 485-3622
Signed By Date
7/8/2015
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