340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
HOLMESBURG PHARMACY
DSH390204 NAZARETH HOSPITAL
Print
Covered Entity Details
Entity Name
NAZARETH HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390204
Entity Address
2601 HOLME AVENUE
PHILADELPHIA, PA 19152
Medicare Provider Number
390204
Participating Start Date
10/1/2016
Last Recertification Date
8/18/2024
Pharmacy Details
Pharmacy Name
HOLMESBURG PHARMACY
Pharmacy Address
8039 FRANKFORD AVENUE
PHILADELPHIA, PA 19136
Pharmacy Comments
Contract Details
Approval Date
10/13/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/30/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David Wajda, CFO
(215) 335-6281
Contract Pharmacy Representative
Sunray
Marcus Tancredi, Director of Pharmacy
(215) 474-4615
Signed By Date
10/13/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session