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LEHIGH VALLEY PHARMACY SERVICES
RRC390133-00 LEHIGH VALLEY HOSPITAL
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Covered Entity Details
Entity Name
LEHIGH VALLEY HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC390133-00
Entity Address
1200 South Cedar Crest Boulevard
Allentown, PA 18103
Medicare Provider Number
390133
Participating Start Date
1/1/2018
Last Recertification Date
8/31/2022
Entity Termination Date
1/1/2023
Pharmacy Details
Pharmacy Name
LEHIGH VALLEY PHARMACY SERVICES
Pharmacy Address
MUHLENBERG
2545 SCHOENERSVILLE RD
BETHLEHEM, PA 18017
Pharmacy Comments
Contract Details
Approval Date
10/16/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/26/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Edward O'Dea, Executive Vice President & Chief Financial Officer
(484) 862-3943
Contract Pharmacy Representative
Lehigh Valley Health Network
Brian Lenich, Administrator
(610) 402-1855
Signed By Date
10/16/2017
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