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RITE AID OF DELAWARE, INC.
CH03301H THREE LOWER COUNTIES COMMUNITY SERVICES, INC.
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Covered Entity Details
Entity Name
THREE LOWER COUNTIES COMMUNITY SERVICES, INC.
Subdivision Name
THREE LOWER COUNTIES COMMUNITY SVCS INC
Type
HRSA-Funded Health Center
340B ID
CH03301H
Entity Address
12145 Elm St
Princess Anne, MD 21853-1358
Grant Number
H80CS00774
Participating Start Date
4/1/2007
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
RITE AID OF DELAWARE, INC.
Pharmacy Address
RITE AID #4910
38169 DUPONT BOULEVARD
SELBYVILLE, DE 19975
Pharmacy Comments
Contract Details
Approval Date
7/3/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
brian edward holland, ceo
(410) 749-1015 Ext: 1621
Contract Pharmacy Representative
CaptureRX
Joe Mast, Rite Aid Key Account Manager
(717) 214-8538
Signed By Date
7/3/2023
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