340B Drug Pricing Program Database

Pharmacy Name

RITE AID OF NEW YORK, INC.

Pharmacy Address

RITE AID #1561
272 HOOSICK STREET
TROY, NY 12180

Pharmacy Comments

Approval Date

10/23/2018

Contract Begin Date

1/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/11/2019
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Lori Santos, CFO
(518) 525-5537

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

10/12/2018