Contract Pharmacy Details

RITE AID OF OHIO, INC.
CH052900 COMMUNITY ACTION COMMITTEE OF PIKE COUNTY

Covered Entity Details

Entity Name

COMMUNITY ACTION COMMITTEE OF PIKE COUNTY

Subdivision Name

N/A

Type

HRSA-Funded Health Center

340B ID

CH052900

Entity Address

941 MARKET STREET
PIKETON, OH 45661

Grant Number

H80CS00399

Participating Start Date

12/1/1992

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

RITE AID OF OHIO, INC.

Pharmacy Address

RITE AID #4708
501 EAST EMMITT AVENUE
WAVERLY, OH 45690

Pharmacy Comments

Contract Details

Approval Date

1/10/2023

Contract Begin Date

1/19/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/22/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Keith Pitts, President and Chief Executive Officer
(216) 770-3409 Ext: 7009

Contract Pharmacy Representative

Rite Aid Pharmacy
Christopher Moen, VP, Strategic Pharmacy Relations
(717) 791-3129

Signed By Date

1/10/2023

340B Drug Pricing Program Database