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RITE AID OF OHIO, INC.
CHC30716-02 KNOX, COUNTY OF
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Covered Entity Details
Entity Name
KNOX, COUNTY OF
Subdivision Name
Mount Vernon Health Center
Type
HRSA-Funded Health Center
340B ID
CHC30716-02
Entity Address
202 West Vine Street
Mount Vernon, OH 43050-3331
Grant Number
H80CS30716
Participating Start Date
4/13/2022
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
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