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THRIFT DRUG, INC.
RRC390045-00 WILLIAMSPORT HOSPITAL & MEDICAL CTR
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Covered Entity Details
Entity Name
WILLIAMSPORT HOSPITAL & MEDICAL CTR
Subdivision Name
Type
Rural Referral Center
340B ID
RRC390045-00
Entity Address
700 HIGH STREET
WILLIAMSPORT, PA 17701
Medicare Provider Number
390045
Participating Start Date
10/1/2024
Last Recertification Date
Pharmacy Details
Pharmacy Name
THRIFT DRUG, INC.
Pharmacy Address
RITE AID #11036
1913 EAST 3RD STREET
WILLIAMSPORT, PA 17701
Pharmacy Comments
Contract Details
Approval Date
8/9/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Roger C Yost, CFO, North-Central PA Region
(570) 321-3175
Contract Pharmacy Representative
RiteAid
Mark Thorn, Manager, Pharmacy Replenishment Program
(734) 347-1086
Signed By Date
7/3/2024
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