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RITE AID OF NEW YORK, INC.
CH02821Q FINGER LAKES MIGRANT HEALTH CARE
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Covered Entity Details
Entity Name
FINGER LAKES MIGRANT HEALTH CARE
Subdivision Name
Penn Yan Community Health Medical Center
Type
HRSA-Funded Health Center
340B ID
CH02821Q
Entity Address
112 Kimball Ave
Penn Yan, NY 14527-1816
Grant Number
H80CS00849
Participating Start Date
4/1/2015
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #442
138 ELM STREET
PENN YAN, NY 14527
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mary A Zelazny, CEO
(315) 531-9102
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
1/16/2024
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