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RITE AID OF PENNSYLVANIA, LLC
CH03048H B-K Health Center, Inc.
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Covered Entity Details
Entity Name
B-K Health Center, Inc.
Subdivision Name
Andrew C. Mazza Memorial Health Center
Type
HRSA-Funded Health Center
340B ID
CH03048H
Entity Address
127 Route 106
Greenfield Township, PA 18407
Grant Number
H80CS00420
Participating Start Date
10/1/2018
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #2768
54 NORTH MAIN STREET
CARBONDALE, PA 18407
Pharmacy Comments
Contract Details
Approval Date
10/6/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/24/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Kristen N Follert, CEO
(570) 278-5157
Contract Pharmacy Representative
Rite Aid
Charlene Kaiser, VP, Managed Care Operations
(918) 645-6652
Signed By Date
10/6/2022
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