Contract Pharmacy Details

ECKERD CORPORATION
DSH390142 ALBERT EINSTEIN MEDICAL CENTER

Covered Entity Details

Entity Name

ALBERT EINSTEIN MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH390142

Entity Address

5501 OLD YORK ROAD
PHILADELPHIA, PA 19141

Medicare Provider Number

390142

Participating Start Date

1/1/2005

Last Recertification Date

8/26/2024

Pharmacy Details

Pharmacy Name

ECKERD CORPORATION

Pharmacy Address

RITE AID #11136
1334 WINDRIM AVENUE
PHILADELPHIA, PA 19141

Pharmacy Comments

Contract Details

Approval Date

7/3/2014

Contract Begin Date

10/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/31/2015
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

GERARD BLANEY, CHIEF FINANCIAL OFFICER
(215) 456-6020

Contract Pharmacy Representative

Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217

Signed By Date

7/3/2014

340B Drug Pricing Program Database