Contract Pharmacy Details

RITE AID OF OHIO, INC.
CHC30716-01 KNOX, COUNTY OF

Covered Entity Details

Entity Name

KNOX, COUNTY OF

Subdivision Name

KCHD/KCCHC Main

Type

HRSA-Funded Health Center

340B ID

CHC30716-01

Entity Address

11660 Upper Gilchrist Rd
Mount Vernon, OH 43050-9084

Grant Number

H80CS30716

Participating Start Date

7/1/2020

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

RITE AID OF OHIO, INC.

Pharmacy Address

RITE AID #3266
117 SOUTH MAIN STREET
FREDERICKTOWN, OH 43019

Pharmacy Comments

Contract Details

Approval Date

4/5/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lane K Belangia, CEO
(740) 392-2222 Ext: 2275

Contract Pharmacy Representative

Rite Aid
Owen McMahon, GVP, Enterprise Pharmaceutical Purchasing
(717) 214-2505

Signed By Date

4/5/2024

340B Drug Pricing Program Database