340B Drug Pricing Program Database
Rite Aid 6811
CAH391301-00 MUNCY VALLEY HOSPITAL - information as of 5/6/2025 1:01:55 AM
Covered Entity Details
Entity Name
MUNCY VALLEY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH391301-00
Entity Address
215 E. WATER STREET
MUNCY, PA 17756
Medicare Provider Number
391301
Participating Start Date
1/1/2011
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
Rite Aid 6811
Pharmacy Address
701 Delran Pkwy
Delran, NJ 08075
Pharmacy Comments
Contract Details
Approval Date
4/9/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Roger C Yost, CFO, North-Central PA Region
(570) 321-3175
Contract Pharmacy Representative
RiteAid
Mark Thorn, Manager, Pharmacy Replenishment Program
(734) 347-1086
Signed By Date
4/9/2025
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