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RITE AID OF PENNSYLVANIA, LLC
HV01699 The Wright Center Medical Group
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Covered Entity Details
Entity Name
The Wright Center Medical Group
Subdivision Name
Type
Ryan White Part C
340B ID
HV01699
Entity Address
501 S Washington Ave
Suite 1000
Scranton, PA 18505
Grant Number
H76HA28747
Participating Start Date
4/1/2009
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #1426
1650 MAIN STREET
OLYPHANT, PA 18447
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
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