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LIFE TREE PHARMACY
RWI19380 Family Service of Chester County
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Covered Entity Details
Entity Name
Family Service of Chester County
Subdivision Name
Type
Ryan White Part A
340B ID
RWI19380
Entity Address
1001 E Lincoln Highway
Coatesville, PA 19320
Grant Number
H89HA00013
Participating Start Date
4/1/2015
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
LIFE TREE PHARMACY
Pharmacy Address
5 BLUE HERON DRIVE
COLLEGEVILLE, PA 19426
Pharmacy Comments
Contract Details
Approval Date
2/9/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Life Tree Pharmacy
Mark Taglianetti, CEO
(610) 489-6640
Signed By Date
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