Contract Pharmacy Details

GENOVESE DRUG STORES, INC.
DSH330027 NASSAU HEALTH CARE CORPORATION

Covered Entity Details

Entity Name

NASSAU HEALTH CARE CORPORATION

Subdivision Name

Nassau University Medical Center

Type

Disproportionate Share Hospital

340B ID

DSH330027

Entity Address

2201 HEMPSTEAD TURNPIKE
EAST MEADOW, NY 11554

Medicare Provider Number

330027

Participating Start Date

1/1/2004

Last Recertification Date

8/12/2024

Pharmacy Details

Pharmacy Name

GENOVESE DRUG STORES, INC.

Pharmacy Address

RITE AID #10614
1910 HEMPSTEAD TURNPIKE
EAST MEADOW, NY 11554

Pharmacy Comments

Contract Details

Approval Date

10/18/2013

Contract Begin Date

1/1/2014

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/6/2015
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

RICHARD PERROTTI, Senior VP FINANCE
(516) 572-6713

Contract Pharmacy Representative

Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217

Signed By Date

10/18/2013

340B Drug Pricing Program Database