Contract Pharmacy Details

RITE AID OF OHIO, INC.
FQHCLA346 HIGHLAND HEALTH PROVIDERS CORPORATION

Covered Entity Details

Entity Name

HIGHLAND HEALTH PROVIDERS CORPORATION

Subdivision Name

Highland Health Providers

Type

Health Center Program Look-Alike

340B ID

FQHCLA346

Entity Address

1487 N. High St.
Suite102
Hillsboro, OH 45133-8496

Grant Number

LALCS00180

Participating Start Date

4/1/2017

Last Recertification Date

2/10/2020

Entity Termination Date

7/1/2020

Pharmacy Details

Pharmacy Name

RITE AID OF OHIO, INC.

Pharmacy Address

RITE AID #142
421 NORTH HIGH STREET
HILLSBORO, OH 45133

Pharmacy Comments

Contract Details

Approval Date

7/2/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2020
Covered Entity Terminated

Contacts

Covered Entity Signing Official

Amanda M Warix, Executive Director
(937) 393-5753

Contract Pharmacy Representative

Rite Aid
Lisa Foster, Manager-Pharmacy
(717) 214-2518

Signed By Date

7/2/2019

340B Drug Pricing Program Database