Transcription of PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE GRANT …
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PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE GRANT …
Copy-ID: GRANT Number: SAP 4100060537 PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE GRANT AGREEMENT PURPOSE OF THE GRANT : To provide Mandatory Managed Care Services to Medicaid consumers in the following counties: Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Forest, Jefferson, McKean, Mercer, Potter, Venango and Warren. AWARD TO: NAME AND ADDRESS: Vista Health Plan, Inc. 1901 Market Street Philadelphia, PA 19103 TELEPHONE NUMBER: 215-241-2015 Mail Final Agreement to: Laura Herzog Director PA Compliance and Regulatory Affairs Keystone Mercy and AmeriHealth Mercy Health Plans 200 Stevens Drive Philadelphia, PA 19113 FEDERAL NUMBER: 23-2408039 HEALTHCHOICES PHYSICAL HEALTH AGREEMENT BETWEEN COMMONWEALTH OF PENNSYLVANIA
between the Commonwealth of Pennsylvania, acting through its Department of Public Welfare (the "Department") and Vista Health Plan, Inc., a Pennsylvania corporation with its principal place of business at 1901 Market Street, Philadelphia, Pennsylvania 19103 (the
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