Contract Pharmacy Details

RITE AID OF PENNSYLVANIA, LLC
FQHCLA394B Wright Center Medical Group, P.C.

Covered Entity Details

Entity Name

Wright Center Medical Group, P.C.

Subdivision Name

The Wright Center for Community Health School Based Practice

Type

Health Center Program Look-Alike

340B ID

FQHCLA394B

Entity Address

1401 Fellows St
Scranton, PA 18504-2222

Grant Number

LALCS33109

Participating Start Date

10/1/2019

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