Contract Pharmacy Details

RITE AID OF NEW YORK, INC.
CH024690 COMMUNITY HEALTH CENTER OF BUFFALO, INC.

Covered Entity Details

Entity Name

COMMUNITY HEALTH CENTER OF BUFFALO, INC.

Subdivision Name

34 Benwood Ave Buffalo, NY 14214

Type

HRSA-Funded Health Center

340B ID

CH024690

Entity Address

34 Benwood
Buffalo, NY 14214-1761

Grant Number

H80CS00157

Participating Start Date

4/1/2003

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

RITE AID OF NEW YORK, INC.

Pharmacy Address

RITE AID #1079
3924 HARLEM ROAD
AMHEREST, NY 14226

Pharmacy Comments

Contract Details

Approval Date

4/10/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/10/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

LaVonne Ansari, CEO
(716) 986-9199 Ext: 1002

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

4/10/2020

340B Drug Pricing Program Database