Contract Pharmacy Details

RITE AID OF NEW YORK, INC.
CHC54598-00 TRILLIUM HEALTH, INC.

Covered Entity Details

Entity Name

TRILLIUM HEALTH, INC.

Subdivision Name

Trillium Health Mobile Access Clinic (MAC)

Type

HRSA-Funded Health Center

340B ID

CHC54598-00

Entity Address

170 Science Pkwy
Rochester, NY 14620-4251

Grant Number

H80CS54598

Participating Start Date

4/1/2025

Last Recertification Date

Pharmacy Details

Pharmacy Name

RITE AID OF NEW YORK, INC.

Pharmacy Address

RITE AID #4894
605 TITUS AVENUE
ROCHESTER, NY 14617

Pharmacy Comments

Contract Details

Approval Date

4/16/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Gregory Clyde Ewing, S.V.P. Compliance, Privacy, Technology & Regulatory Affairs/CCO
(585) 545-7218

Contract Pharmacy Representative

RiteAid
Mark Thorn, Manager, Pharmacy Replenishment Program
(734) 347-1086

Signed By Date

4/16/2025

340B Drug Pricing Program Database