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RITE AID OF OHIO, INC.
CH056820 COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC
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Covered Entity Details
Entity Name
COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC
Subdivision Name
DBA LISBON COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH056820
Entity Address
7880 Lincole Pl
Lisbon, OH 44432-8322
Grant Number
H80CS00197
Participating Start Date
7/1/1997
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
RITE AID OF OHIO, INC.
Pharmacy Address
RITE AID #3603
220 THIRD STREET
WELLSVILLE, OH 43968
Pharmacy Comments
Contract Details
Approval Date
4/19/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/20/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Thomas E Andrews, CEO
(330) 424-7221 Ext: 104
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
4/19/2019
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