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RITE AID OF NEW YORK, INC.
RWII12203 The Albany Damien Center, Inc.
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Covered Entity Details
Entity Name
The Albany Damien Center, Inc.
Subdivision Name
Type
Ryan White Part B
340B ID
RWII12203
Entity Address
728 Madison Ave, Ste 100
Albany, NY 12208-3302
Grant Number
X07HA00044
Participating Start Date
10/1/2015
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #661
2025 WESTERN AVENUE
ALBANY, NY 12203
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2020
Agreement registered in error
Contacts
Covered Entity Signing Official
Perry Junjulas, Executive Director
(518) 449-7119 Ext: 102
Contract Pharmacy Representative
Rite Aid
Lisa Foster, Manager-Pharmacy
(717) 214-2518
Signed By Date
1/15/2020
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