Contract Pharmacy Details

RITE AID OF NEW YORK, INC.
CHC29018-00 NEW YORK CITY HEALTH AND HOSPITALS

Entity Name

NEW YORK CITY HEALTH AND HOSPITALS

Subdivision Name

Cumberland Diagnostic and Treatment Center

Type

HRSA-Funded Health Center

340B ID

CHC29018-00

Entity Address

100 N Portland Ave
Brooklyn, NY 11205-2005

Grant Number

H80CS29018

Participating Start Date

4/1/2016

Last Recertification Date

2/13/2024

Pharmacy Name

RITE AID OF NEW YORK, INC.

Pharmacy Address

RITE AID #3627
1154 CLARKSON AVENUE
BROOKLYN, NY 11212

Pharmacy Comments

Approval Date

1/11/2022

Contract Begin Date

4/1/2022

Carve-In Effective Date

Contract Comments

Contract Termination Date

7/5/2022

Termination Reason

Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Paul Albertson, Vice President
(212) 748-2256

Signed By Date

1/11/2022

Contract Pharmacy Representative

Rite Aid
David Bell, Rep
(717) 761-2633 Ext: 5311