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VALUE SPECIALTY PHARMACY
STD15233 Central Outreach Wellness Center, LLC
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Covered Entity Details
Entity Name
Central Outreach Wellness Center, LLC
Subdivision Name
Type
Sexually Transmitted Diseases
340B ID
STD15233
Entity Address
127 Anderson Street
Suite 101
Pittsburgh, PA 15212
Grant Number
NH25PS005144
Participating Start Date
7/1/2015
Last Recertification Date
5/7/2024
Pharmacy Details
Pharmacy Name
VALUE SPECIALTY PHARMACY
Pharmacy Address
4200 INDUSTRIAL PARK DR
ALTOONA, PA 16602
Pharmacy Comments
Contract Details
Approval Date
1/13/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/13/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Stacy Lane, Owner
(412) 608-8313
Contract Pharmacy Representative
Eric Fromhart, Business Development Manager
(814) 283-1615
Signed By Date
1/13/2016
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