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RITE AID OF PENNSYLVANIA, LLC
DSH390329 EINSTEIN MEDICAL CENTER MONTGOMERY
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Covered Entity Details
Entity Name
EINSTEIN MEDICAL CENTER MONTGOMERY
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390329
Entity Address
559 WEST GERMANTOWN PIKE
EAST NORRITON, PA 19403
Medicare Provider Number
390329
Participating Start Date
7/1/2016
Last Recertification Date
8/20/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #3389
2674 EGYPT ROAD
AUDUBON, PA 19403
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Beth Duffy, Chief Operating Officer
(484) 622-7004
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
10/15/2020
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