340B Drug Pricing Program Database

Pharmacy Name

RITE AID OF PENNSYLVANIA, LLC

Pharmacy Address

RITE AID #3681
5440 LANSDOWNE AVENUE
PHILADELPHIA, PA 19131

Pharmacy Comments

Approval Date

2/2/2023

Contract Begin Date

4/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/28/2023
Pharmacy closed

Covered Entity Signing Official

Yonathan M Kebede, Vice President, Operations
(614) 323-9829

Contract Pharmacy Representative

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

Signed By Date

1/17/2023