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SHOP RITE PHARMACY #558
CH032960 WESTSIDE FAMILY HEALTHCARE, INC.
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Covered Entity Details
Entity Name
WESTSIDE FAMILY HEALTHCARE, INC.
Subdivision Name
Westside Family Healthcare - Administration Office
Type
HRSA-Funded Health Center
340B ID
CH032960
Entity Address
300 Water Street
Suite 200
Wilmington, DE 19801-5043
Grant Number
H80CS00789
Participating Start Date
4/1/2000
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
SHOP RITE PHARMACY #558
Pharmacy Address
1300 ROCKY RUN PARKWAY
WILMINGTON, DE 19803
Pharmacy Comments
Contract Details
Approval Date
4/12/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DONNA M. GOODMAN, VP AND CFO/COO
(302) 656-8292
Contract Pharmacy Representative
Wakefern/ShopRite
Jigar Patel, Main 340B Contact
(302) 225-6888
Signed By Date
4/12/2019
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