Contract Pharmacy Details

RITE AID OF PENNSYLVANIA, LLC
CH03122H N PENN COMPREHENSIVE HEALTH SVCS

Covered Entity Details

Entity Name

N PENN COMPREHENSIVE HEALTH SVCS

Subdivision Name

LAWRENCEVILLE LAUREL HEALTH CENTER

Type

HRSA-Funded Health Center

340B ID

CH03122H

Entity Address

32 E Lawrence Rd
Lawrenceville, PA 16929-8801

Grant Number

H80CS00682

Participating Start Date

1/1/2009

Last Recertification Date

3/5/2025

Pharmacy Details

Pharmacy Name

RITE AID OF PENNSYLVANIA, LLC

Pharmacy Address

RITE AID #561
2968 ELMIRA STREET
SAYRE, PA 18840

Pharmacy Comments

Contract Details

Approval Date

4/15/2022

Contract Begin Date

7/1/2022

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Ronald M Gilbert, CFO
(570) 828-3869

Contract Pharmacy Representative

Rite Aid Pharmacy
Christopher Moen, VP, Strategic Pharmacy Relations
(717) 791-3129

Signed By Date

4/15/2022

340B Drug Pricing Program Database