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RITE AID OF PENNSYLVANIA, LLC
CH034140 SPECTRUM HEALTH SERVICES, INC.
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Covered Entity Details
Entity Name
SPECTRUM HEALTH SERVICES, INC.
Subdivision Name
Spectrum Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH034140
Entity Address
5201 Haverford Avenue
Philadelphia, PA 19139
Grant Number
H80CS00389
Participating Start Date
1/1/2000
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #478
5400 RISING SUN AVENUE
PHILADELPHIA, PA 19120
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shawna L Russell-Young, Chief Compliance Officer
(215) 668-0847
Contract Pharmacy Representative
Rite Aid
Owen McMahon, GVP, Enterprise Pharmaceutical Purchasing
(717) 214-2505
Signed By Date
4/15/2025
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