Contract Pharmacy Details

RITE AID OF NEW YORK, INC.
CH021887D SUNSET PARK HEALTH COUNCIL, INC.

Covered Entity Details

Entity Name

SUNSET PARK HEALTH COUNCIL, INC.

Subdivision Name

PARK RIDGE FAMILY HEALTH CENTER at NYU LANGONE

Type

HRSA-Funded Health Center

340B ID

CH021887D

Entity Address

6317 - 4TH AVE
BROOKLYN, NY 11220

Grant Number

H80CS07914

Participating Start Date

1/1/2004

Last Recertification Date

2/26/2025

Pharmacy Details

Pharmacy Name

RITE AID OF NEW YORK, INC.

Pharmacy Address

RITE AID #3879
6900 4TH AVENUE
BROOKLYN, NY 11209

Pharmacy Comments

Contract Details

Approval Date

4/6/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Larry K. McReynolds, Executive Director
(718) 630-7216

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

4/6/2023

340B Drug Pricing Program Database