Contract Pharmacy Details

ECKERD CORPORATION
FQHCLA342 TRILLIUM HEALTH, INC.

Covered Entity Details

Entity Name

TRILLIUM HEALTH, INC.

Subdivision Name

Trillium Health at Monroe Square

Type

Health Center Program Look-Alike

340B ID

FQHCLA342

Entity Address

259 Monroe Avenue Suite 100
Rochester, NY 14607-3632

Grant Number

LALCS00182

Participating Start Date

1/1/2017

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

ECKERD CORPORATION

Pharmacy Address

RITE AID #10849
101 S. MAIN STREET
NEWARK, NY 14513

Pharmacy Comments

Contract Details

Approval Date

7/15/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Gregory Clyde Ewing, S.V.P. Compliance, Privacy, Technology & Regulatory Affairs/CCO
(585) 545-7218

Contract Pharmacy Representative

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

Signed By Date

7/15/2020

340B Drug Pricing Program Database