Contract Pharmacy Details

RITE AID OF PENNSYLVANIA, LLC
FQHCLA394C 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 South Scranton Intermediate School

Type

Health Center Program Look-Alike

340B ID

FQHCLA394C

Entity Address

355 Maple St
Scranton, PA 18505-1215

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 #2426
39 WEST SIDE MALL
EDWARDSVILLE, PA 18704-3113

Pharmacy Comments

Contract Details

Approval Date

4/8/2024

Contract Begin Date

7/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/4/2024
Agreement registered in error

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