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ECKERD CORPORATION
DSH390027 TEMPLE UNIVERSITY HOSPITAL
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Covered Entity Details
Entity Name
TEMPLE UNIVERSITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH390027
Entity Address
3401 North Broad Street
PHILADELPHIA, PA 19140
Medicare Provider Number
390027
Participating Start Date
1/1/2004
Last Recertification Date
8/17/2024
Pharmacy Details
Pharmacy Name
ECKERD CORPORATION
Pharmacy Address
RITE AID #11136
1334 WINDRIM AVENUE
PHILADELPHIA, PA 19141
Pharmacy Comments
Contract Details
Approval Date
4/19/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Robert H. Lux, Vice President, Chief Financial Officer & Treasurer
(215) 707-3802
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
4/19/2013
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