Contract Pharmacy Details

RITE AID OF PENNSYLVANIA, LLC
CH036670 RESOURCES FOR HUMAN DEVELOPMENT, INC.

Covered Entity Details

Entity Name

RESOURCES FOR HUMAN DEVELOPMENT, INC.

Subdivision Name

Family Practice and Counseling Network-Admin Office

Type

HRSA-Funded Health Center

340B ID

CH036670

Entity Address

4700 WISSAHICKON AVE ,
SUITE 126
PHILADELPHIA, PA 19144-4248

Grant Number

H80CS00718

Participating Start Date

7/1/1995

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

RITE AID OF PENNSYLVANIA, LLC

Pharmacy Address

RITE AID #2451
5214-30 BALTIMORE AVENUE
PHILADELPHIA, PA 19143

Pharmacy Comments

Contract Details

Approval Date

10/17/2022

Contract Begin Date

1/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/1/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Marco Giordano, CEO
(215) 951-0300

Contract Pharmacy Representative

Rite Aid
Charlene Kaiser, VP, Managed Care Operations
(918) 645-6652

Signed By Date

10/17/2022

340B Drug Pricing Program Database