Contract Pharmacy Details

RITE AID NEW JERSEY, INC.
DSH310027 TRINITAS REGIONAL MEDICAL CENTER

Covered Entity Details

Entity Name

TRINITAS REGIONAL MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH310027

Entity Address

225 WILLIAMSON ST
ELIZABETH, NJ 07202

Medicare Provider Number

310027

Participating Start Date

1/1/2005

Last Recertification Date

9/1/2024

Pharmacy Details

Pharmacy Name

RITE AID NEW JERSEY, INC.

Pharmacy Address

RITE AID #1105
160 WASHINGTON AVENUE
CARTERET, NJ 07008

Pharmacy Comments

Contract Details

Approval Date

1/21/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/8/2018
Ownership change

Contacts

Covered Entity Signing Official

KAREN LUMPP, CFO & SENIOR VP
(908) 994-8174

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President Managed Care
(717) 214-8538

Signed By Date

1/21/2016

340B Drug Pricing Program Database