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RITE AID OF PENNSYLVANIA, LLC
CH034140 SPECTRUM HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
SPECTRUM HEALTH SERVICES, INC.
Subdivision Name
Spectrum Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH034140
Entity Address
5201 Haverford Avenue
Philadelphia, PA 19139
Grant Number
H80CS00389
Participating Start Date
1/1/2000
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #2790
1406 CECIL B MOORE AVE
PHILADELPHIA, PA 19121
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/24/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Stephanie Wroten, Chief Programs and Develop
(215) 471-2761 Ext: 3256
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
7/12/2019
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