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RITE AID OF NEW YORK, INC.
CHC26630-00 JERICHO ROAD MINISTRIES INC.
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Covered Entity Details
Entity Name
JERICHO ROAD MINISTRIES INC.
Subdivision Name
Jericho Road CHC (Barton)
Type
HRSA-Funded Health Center
340B ID
CHC26630-00
Entity Address
184 BARTON STREET
Buffalo, NY 14213-1573
Grant Number
H80CS26630
Participating Start Date
7/1/2014
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #1511
2474 BAILEY AVENUE
BUFFALO, NY 14215
Pharmacy Comments
Contract Details
Approval Date
7/16/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/2/2020
CE terminated due to audit finding
Contacts
Covered Entity Signing Official
Brett L Lawton, Chief Operating Officer
(716) 348-3000 Ext: 430
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
7/16/2018
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