Contract Pharmacy Details

RITE AID OF OHIO, INC.
CH053086D Lifecare Family Health and Dental Center, Inc

Covered Entity Details

Entity Name

Lifecare Family Health and Dental Center, Inc

Subdivision Name

Massillon Professional Building

Type

HRSA-Funded Health Center

340B ID

CH053086D

Entity Address

830 Amherst Rd NE
Massillon, OH 44646-8525

Grant Number

H80CS06654

Participating Start Date

10/1/2020

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

RITE AID OF OHIO, INC.

Pharmacy Address

RITE AID #3095
242 LINCOLN WAY WEST
MASSILLON, OH 44647

Pharmacy Comments

Contract Details

Approval Date

1/15/2024

Contract Begin Date

4/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/27/2024
Pharmacy closed

Contacts

Covered Entity Signing Official

Eric Niemeyer, CEO
(330) 454-2000 Ext: 150

Contract Pharmacy Representative

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

Signed By Date

1/15/2024

340B Drug Pricing Program Database