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RITE AID OF PENNSYLVANIA, LLC
HV032130 LEHIGH VALLEY HOSPITAL
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Covered Entity Details
Entity Name
LEHIGH VALLEY HOSPITAL
Subdivision Name
Type
Ryan White Part C
340B ID
HV032130
Entity Address
1627 Chew Street, Third Floor
Allentown, PA 18102
Grant Number
6 H76HA00078-33-04
Participating Start Date
4/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #1355
504 MARION LN
BRODHEADSVILLE, PA 18322-7064
Pharmacy Comments
Contract Details
Approval Date
4/9/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/7/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Thomas Marchozzi, Executive Vice President & Chief Financial Officer
(484) 862-3943
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
4/9/2020
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