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RITE AID OF TENNESSEE, INC.
CH04123D OCOEE REGIONAL HEALTH CORPORATION
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Covered Entity Details
Entity Name
OCOEE REGIONAL HEALTH CORPORATION
Subdivision Name
GRUNDY COUNTY PRIMARY CARE CENTER
Type
HRSA-Funded Health Center
340B ID
CH04123D
Entity Address
10120 SR 56
Coalmont, TN 37313-2505
Grant Number
H80CS00762
Participating Start Date
7/1/2015
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
RITE AID OF TENNESSEE, INC.
Pharmacy Address
RITE AID #1296
1805 DALTON PIKE, SE
CLEVELAND, TN 37311
Pharmacy Comments
Contract Details
Approval Date
6/5/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/19/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
BILL MOATS, CEO
(423) 338-8995 Ext: 1212
Contract Pharmacy Representative
Rite Aid
Chris Hall, Senior Vice President
(717) 214-8834
Signed By Date
6/5/2015
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