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RITE AID OF NEW YORK, INC.
CHC26630-05 JERICHO ROAD MINISTRIES INC.
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Covered Entity Details
Entity Name
JERICHO ROAD MINISTRIES INC.
Subdivision Name
Jericho Road Community Health Center Breckenridge
Type
HRSA-Funded Health Center
340B ID
CHC26630-05
Entity Address
182 Breckenridge St
Buffalo, NY 14213-1562
Grant Number
H80CS26630
Participating Start Date
10/1/2021
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #1962
284 CONNECTICUT STREET
BUFFALO, NY 14213
Pharmacy Comments
Contract Details
Approval Date
7/12/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Myron Glick, Chief Executive Officer
(716) 348-3000
Contract Pharmacy Representative
Rite Aid
Owen McMahon, GVP, Enterprise Pharmaceutical Purchasing
(717) 214-2505
Signed By Date
7/12/2023
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