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RITE AID OF NEW YORK, INC.
CH021887A SUNSET PARK HEALTH COUNCIL, INC.
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Covered Entity Details
Entity Name
SUNSET PARK HEALTH COUNCIL, INC.
Subdivision Name
FAMILY PHYSICIAN FAMILY HEALTH CENTER at NYU Langone
Type
HRSA-Funded Health Center
340B ID
CH021887A
Entity Address
5616 - 6TH AVE
BROOKLYN, NY 11220
Grant Number
H80CS07914
Participating Start Date
1/1/2004
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #4712
9302 3RD AVENUE
BROOKLYN, NY 11209
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Larry K. McReynolds, Executive Director
(718) 630-7216
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
10/15/2020
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