Contract Pharmacy Details

RITE AID OF PENNSYLVANIA, LLC
FQHCLA394L Wright Center Medical Group, P.C., The

Covered Entity Details

Entity Name

Wright Center Medical Group, P.C., The

Subdivision Name

The Wright Center for Community Health Wayne Practice

Type

Health Center Program Look-Alike

340B ID

FQHCLA394L

Entity Address

1855 Fair Ave
Honesdale, PA 18431-2121

Grant Number

LALCS33109

Participating Start Date

1/1/2020

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

RITE AID OF PENNSYLVANIA, LLC

Pharmacy Address

RITE AID #1021
401-403 SOUTH MAIN STREET
OLD FORGE, PA 18518

Pharmacy Comments

Contract Details

Approval Date

4/8/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Jignesh Sheth, Senior VP for Clinical Operations
(570) 687-4232

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

4/8/2024

340B Drug Pricing Program Database