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RITE AID OF MARYLAND, INC.
CH033180 BALTIMORE MEDICAL SYSTEM, INC.
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Covered Entity Details
Entity Name
BALTIMORE MEDICAL SYSTEM, INC.
Subdivision Name
BMS at Yard 56
Type
HRSA-Funded Health Center
340B ID
CH033180
Entity Address
5525 Eastern Avenue
Suite 301
Baltimore, MD 21224-2029
Grant Number
H80CS00800
Participating Start Date
10/1/1998
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
RITE AID OF MARYLAND, INC.
Pharmacy Address
RITE AID #2204
2801 FOSTER AVENUE
BALTIMORE, MD 21224
Pharmacy Comments
Contract Details
Approval Date
1/21/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shirley Sutton, Chief Executive Officer
(410) 558-4891
Contract Pharmacy Representative
Rite Aid
Lisa Foster, Manager-Pharmacy
(717) 214-2518
Signed By Date
1/21/2020
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