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RITE AID OF PENNSYLVANIA, LLC
FQHCLA431C VALLEY HEALTH PARTNERS COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
VALLEY HEALTH PARTNERS COMMUNITY HEALTH CENTER
Subdivision Name
Lehigh Valley Physicians Practice PCP
Type
Health Center Program Look-Alike
340B ID
FQHCLA431C
Entity Address
1627 Chew St
STE 101
Allentown, PA 18102
Grant Number
LALCS45056
Participating Start Date
1/1/2022
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #6778
27 N 7TH ST STE 100
ALLENTOWN, PA 18101-1357
Pharmacy Comments
Contract Details
Approval Date
12/22/2022
Contract Begin Date
12/22/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Veronica Gonzalez, Chief Executive Officer
(610) 969-2728
Contract Pharmacy Representative
Rite-Aid
Charlene Kaiser, VP, Managed Care
(999) 999-9999
Signed By Date
12/22/2022
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