Contract Pharmacy Details

RITE AID OF NEW YORK, INC.
CHC29018-00 NEW YORK CITY HEALTH AND HOSPITALS

Covered Entity Details

Entity Name

NEW YORK CITY HEALTH AND HOSPITALS

Subdivision Name

Cumberland Diagnostic and Treatment Center

Type

HRSA-Funded Health Center

340B ID

CHC29018-00

Entity Address

100 N Portland Ave
Brooklyn, NY 11205-2005

Grant Number

H80CS29018

Participating Start Date

4/1/2016

Last Recertification Date

3/5/2025

Pharmacy Details

Pharmacy Name

RITE AID OF NEW YORK, INC.

Pharmacy Address

RITE AID #4893
1950 FULTON STREET
BROOKLYN, NY 11233

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

7/15/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Deborah Alyse Brown, Senior Vice President, Chief External Affairs Officer
(347) 947-0446

Contract Pharmacy Representative

Rite Aid
David Bell, Rep
(717) 761-2633 Ext: 5311

Signed By Date

10/17/2022

340B Drug Pricing Program Database