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ECKERD CORPORATION
RRC330140-00 ST. JOSEPHS HOSPITAL HEALTH CENTER
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Covered Entity Details
Entity Name
ST. JOSEPHS HOSPITAL HEALTH CENTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC330140-00
Entity Address
301 PROSPECT AVENUE
SYRACUSE, NY 13203
Medicare Provider Number
330140
Participating Start Date
10/1/2021
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
ECKERD CORPORATION
Pharmacy Address
RITE AID #10763
5380 WEST TAFT ROAD
NORTH SYRACUSE, NY 13212
Pharmacy Comments
Contract Details
Approval Date
1/18/2022
Contract Begin Date
1/24/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Meredith Anne Price, Chief Financial Officer
(315) 448-5888
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
1/18/2022
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