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RITE AID OF NEW YORK, INC.
CH020560 Mosaic Health, Inc.
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Covered Entity Details
Entity Name
Mosaic Health, Inc.
Subdivision Name
Mosaic Health Finger Lakes Administration
Type
HRSA-Funded Health Center
340B ID
CH020560
Entity Address
1 S Washington Street
Suite 300
Rochester, NY 14614-1134
Grant Number
H80CS00167
Participating Start Date
9/9/2005
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #1722
670 THURSTON ROAD
ROCHESTER, NY 14619
Pharmacy Comments
Contract Details
Approval Date
11/9/2012
Contract Begin Date
10/27/2012
Carve-In Effective Date
Contract Comments
11/09/2012 - public health emergency declared in the state of NY effective 10/27/2012
Contract Termination Date
Termination Reason
2/20/2018
Ownership change
Contacts
Covered Entity Signing Official
Lisa Olscamp, CFO
(585) 325-2280 Ext: 7318
Contract Pharmacy Representative
Rite Aid
Ruth Lightner, Director
(717) 731-6524
Signed By Date
10/15/2012
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