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ECKERD CORPORATION
DSH330096 JONES MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
JONES MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330096
Entity Address
191 North Main Street
WELLSVILLE, NY 14895-0072
Medicare Provider Number
330096
Participating Start Date
10/1/2017
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
ECKERD CORPORATION
Pharmacy Address
RITE AID #10823
12208 N.Y. STATE ROUTE 16
P.O.BOX 617
YORKSHIRE, NY 14173
Pharmacy Comments
Contract Details
Approval Date
7/7/2020
Contract Begin Date
7/21/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/30/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Helms, Vice President of Finance
(585) 596-4002
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
7/7/2020
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