340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RITE AID OF NEW HAMPSHIRE, INC.
HV00812D Mary Hitchcock Memorial Hospital dba Ryan White Program
Print
Covered Entity Details
Entity Name
Mary Hitchcock Memorial Hospital dba Ryan White Program
Subdivision Name
Ryan White Part C
Type
Ryan White Part C
340B ID
HV00812D
Entity Address
580 Court Street
Keene, NH 03431
Grant Number
H76HA31654
Participating Start Date
1/1/2023
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW HAMPSHIRE, INC.
Pharmacy Address
RITE AID #1070
420 DANIEL WEBSTER HIGHWAY
MERRIMACK, NH 03054
Pharmacy Comments
Contract Details
Approval Date
4/11/2023
Contract Begin Date
4/25/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/6/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Staci A Hermann, CHIEF PHARMACY OFFICER
(603) 653-3160
Contract Pharmacy Representative
Rite Aid
Charlene Kaiser, VP, Managed Care Operations
(918) 645-6652
Signed By Date
4/11/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session