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RITECHOICE PHARMACY V
CH03414A SPECTRUM HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
SPECTRUM HEALTH SERVICES, INC.
Subdivision Name
BROAD STREET HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH03414A
Entity Address
1415 N Broad St STE 224
Philadelphia, PA 19122-3325
Grant Number
H80CS00389
Participating Start Date
10/1/2016
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
RITECHOICE PHARMACY V
Pharmacy Address
5201 HAVERFORD AVE
FL 1
PHILADELPHIA, PA 19139-1401
Pharmacy Comments
Contract Details
Approval Date
7/11/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephanie Wroten, Chief Programs and Develop
(215) 471-2761 Ext: 3256
Contract Pharmacy Representative
Rite Choice IV
Adam Accay, President
(215) 500-2223
Signed By Date
7/11/2019
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