Contract Pharmacy Details

RITE AID OF NEW JERSEY, INC.
CHC00064-02 ODA PRIMARY HEALTH CARE CENTER, INC.

Covered Entity Details

Entity Name

ODA PRIMARY HEALTH CARE CENTER, INC.

Subdivision Name

Park Avenue Primary Health Care Center

Type

HRSA-Funded Health Center

340B ID

CHC00064-02

Entity Address

517 Park Ave
Brooklyn, NY 11205-1631

Grant Number

H80CS00064

Participating Start Date

10/1/2013

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

RITE AID OF NEW JERSEY, INC.

Pharmacy Address

RITE AID #149
1097 BROADWAY
BAYONNE, NJ 07002

Pharmacy Comments

Contract Details

Approval Date

7/9/2019

Contract Begin Date

10/1/2019

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/18/2024
OPA Terminated due to audit finding

Contacts

Covered Entity Signing Official

Joseph Deutsch, Chief Executive Officer
(718) 260-4600 Ext: 301

Contract Pharmacy Representative

Rite Aide
Lisa Foster, Manager Pharmaceutical Replenishment Program
(717) 214-2518

Signed By Date

7/9/2019

340B Drug Pricing Program Database