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RITE AID OF NEW YORK, INC.
CHC29018-00 NEW YORK CITY HEALTH AND HOSPITALS
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Covered Entity Details
Entity Name
NEW YORK CITY HEALTH AND HOSPITALS
Subdivision Name
Cumberland Diagnostic and Treatment Center
Type
HRSA-Funded Health Center
340B ID
CHC29018-00
Entity Address
100 N Portland Ave
Brooklyn, NY 11205-2005
Grant Number
H80CS29018
Participating Start Date
4/1/2016
Last Recertification Date
3/5/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #4873
55-60 MYRTLE AVENUE
RIDGEWOOD, NY 11385
Pharmacy Comments
Contract Details
Approval Date
1/4/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/10/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paul Albertson, Vice President
(212) 748-2256
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
1/4/2019
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