340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RITE AID DRUG PALACE, INC.
DSH330128 ELMHURST HOSPITAL CENTER (NYCHHC)
Print
Covered Entity Details
Entity Name
ELMHURST HOSPITAL CENTER (NYCHHC)
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330128
Entity Address
79-01 BROADWAY
ELMHURST, NY 11373
Medicare Provider Number
330128
Participating Start Date
12/1/1992
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
RITE AID DRUG PALACE, INC.
Pharmacy Address
RITE AID #1805
33-01 30TH AVENUE
ASTORIA, NY 11103
Pharmacy Comments
Contract Details
Approval Date
11/8/2012
Contract Begin Date
10/27/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Antonio Martin, Ececutive Vice President & Chief Operating Officier
(212) 788-3479
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
10/27/2012
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session