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RITECHOICE PHARMACY IV
CH034140 SPECTRUM HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
SPECTRUM HEALTH SERVICES, INC.
Subdivision Name
Spectrum Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH034140
Entity Address
5201 Haverford Avenue
Philadelphia, PA 19139
Grant Number
H80CS00389
Participating Start Date
1/1/2000
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
RITECHOICE PHARMACY IV
Pharmacy Address
4700 WISSAHICKON AVE
BUILDING E, SUITE 100
PHILADELPHIA, PA 19144
Pharmacy Comments
Contract Details
Approval Date
10/12/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/30/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Stephanie Wroten, Chief Programs and Develop
(215) 471-2761 Ext: 3256
Contract Pharmacy Representative
Rite Choice IV
Adam Accay, President
(215) 500-2223
Signed By Date
10/12/2018
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