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RITE AID OF PENNSYLVANIA, LLC
CH031670 PUBLIC HEALTH MANAGEMENT CORPORATION
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Covered Entity Details
Entity Name
PUBLIC HEALTH MANAGEMENT CORPORATION
Subdivision Name
Public Health Management Corporation
Type
HRSA-Funded Health Center
340B ID
CH031670
Entity Address
Centre Square East
1500 Market Street
Philadelphia, PA 19102-2100
Grant Number
H80CS00016
Participating Start Date
7/1/2004
Last Recertification Date
2/28/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #2451
5214-30 BALTIMORE AVENUE
PHILADELPHIA, PA 19143
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Cohen, President and CEO
(215) 985-2501
Contract Pharmacy Representative
Capture Rx
Rhynada Benavidez, Sales Operation Specialist
(210) 910-9144
Signed By Date
10/15/2021
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