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RITE AID OF PENNSYLVANIA, LLC
CH03230H KEYSTONE RURAL HEALTH CONSORTIA INC
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Covered Entity Details
Entity Name
KEYSTONE RURAL HEALTH CONSORTIA INC
Subdivision Name
Ridgway Area Medical Center
Type
HRSA-Funded Health Center
340B ID
CH03230H
Entity Address
49 Ridgmont Drive
1
Ridgway, PA 15853
Grant Number
H80CS00688
Participating Start Date
10/1/2017
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #1406
521 NORTH FRALEY STREET
KANE, PA 16735
Pharmacy Comments
Contract Details
Approval Date
4/9/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kristie Bennardi, CEO
(814) 486-1115
Contract Pharmacy Representative
Rite Aid
Owen McMahon, Group Vice President-Enterprise pharmaceutical Purchasing
(717) 732-0711
Signed By Date
4/9/2024
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