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MEDICINE SHOPPE 1865
CH03029G HAMILTON HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
HAMILTON HEALTH CENTER, INC.
Subdivision Name
Union Deposit Family Practice
Type
HRSA-Funded Health Center
340B ID
CH03029G
Entity Address
891 S Arlington Ave
Harrisburg, PA 17109-5004
Grant Number
H80CS00659
Participating Start Date
4/1/2018
Last Recertification Date
2/10/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
MEDICINE SHOPPE 1865
Pharmacy Address
110 S. 17TH STREET
HARRISBURG, PA 17104
Pharmacy Comments
7/3/2013: OPA request to add DEA number.
Contract Details
Approval Date
4/15/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
JEANNINE PETERSON, EXECUTIVE DIRECTOR
(717) 230-3910
Contract Pharmacy Representative
CL Cressler Inc
Helen Clark, Chief Operating Officer
(717) 766-6191
Signed By Date
4/15/2018
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