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RITE AID OF OHIO, INC.
CH050580 NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES, INC.
Subdivision Name
NORTHEAST OHIO NEIGHBORHOOD HEALTH SERVICES
Type
HRSA-Funded Health Center
340B ID
CH050580
Entity Address
8300 Hough Ave
Cleveland, OH 44103-4247
Grant Number
H80CS00191
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
RITE AID OF OHIO, INC.
Pharmacy Address
RITE AID #2640
5411 SUPERIOR AVENUE
CLEVELAND, OH 44103
Pharmacy Comments
Contract Details
Approval Date
4/14/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Willie F. Austin, President/CEO
(216) 231-7700 Ext: 1112
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
4/14/2014
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