Contract Pharmacy Details

THRIFT DRUG, INC.
CAH391300-00 GEISINGER JERSEY SHORE HOSPITAL

Covered Entity Details

Entity Name

GEISINGER JERSEY SHORE HOSPITAL

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH391300-00

Entity Address

1020 THOMPSON ST
JERSEY SHORE, PA 17740

Medicare Provider Number

391300

Participating Start Date

1/1/2011

Last Recertification Date

8/15/2024

Pharmacy Details

Pharmacy Name

THRIFT DRUG, INC.

Pharmacy Address

RITE AID #11036
1913 EAST 3RD STREET
WILLIAMSPORT, PA 17701

Pharmacy Comments

Contract Details

Approval Date

4/12/2023

Contract Begin Date

7/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/30/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Tammy Harding Anderer, Chief Administrative Officer
(570) 398-0100

Contract Pharmacy Representative

RiteAid
Mark Thorn, Manager, Pharmacy Replenishment Program
(734) 347-1086

Signed By Date

4/12/2023

340B Drug Pricing Program Database