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RITE AID OF PENNSYLVANIA, LLC
CH03406A PRIMARY HEALTH NETWORK, INC.
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Covered Entity Details
Entity Name
PRIMARY HEALTH NETWORK, INC.
Subdivision Name
FARRELL HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH03406A
Entity Address
602 Roemer Blvd
Farrell, PA 16121-1902
Grant Number
H80CS00663
Participating Start Date
1/1/2003
Last Recertification Date
2/26/2018
Entity Termination Date
4/1/2019
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #1494
1120 PHILADELPHIA AVENUE
NORTHERN CAMBRIA, PA 15714
Pharmacy Comments
Contract Details
Approval Date
10/15/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
John D. Laeng, CEO
(724) 342-3002 Ext: 215
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
10/15/2014
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