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RITE AID OF PENNSYLVANIA, LLC
CH03414B SPECTRUM HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
SPECTRUM HEALTH SERVICES, INC.
Subdivision Name
Reed Street Health Center
Type
HRSA-Funded Health Center
340B ID
CH03414B
Entity Address
1325 South 33rd Street
Suite 300
Philadelphia, PA 19146
Grant Number
H80CS00389
Participating Start Date
10/1/2016
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #2451
5214-30 BALTIMORE AVENUE
PHILADELPHIA, PA 19143
Pharmacy Comments
Contract Details
Approval Date
4/3/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/24/2023
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 Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
4/3/2019
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