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RITE AID OF NEW YORK, INC.
CH020180 OAK ORCHARD COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
OAK ORCHARD COMMUNITY HEALTH CENTER, INC.
Subdivision Name
OAK ORCHARD COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH020180
Entity Address
300 West Ave
Brockport, NY 14420-1118
Grant Number
H80CS00170
Participating Start Date
10/14/2008
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #1621
153 PROSPECT STREET
ATTICA, NY 14011
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Carol A. White, Cfo
(585) 637-3905 Ext: 224
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
7/15/2019
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