Contract Pharmacy Details

RITE AID OF NEW YORK, INC.
CH020160 SYRACUSE COMMUNITY HEALTH CENTER, INC.

Covered Entity Details

Entity Name

SYRACUSE COMMUNITY HEALTH CENTER, INC.

Subdivision Name

SYRACUSE COMMUNITY HEALTH CENTER, INC.

Type

HRSA-Funded Health Center

340B ID

CH020160

Entity Address

819 S Salina St
Syracuse, NY 13202-3527

Grant Number

H80CS00434

Participating Start Date

12/1/1992

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

RITE AID OF NEW YORK, INC.

Pharmacy Address

RITE AID #636
519 BUTTERNUT STREET
SYRACUSE, NY 13208

Pharmacy Comments

Contract Details

Approval Date

5/2/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Leola Rodgers, President and CEO
(315) 476-7921 Ext: 2427

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

5/2/2017

340B Drug Pricing Program Database