Contract Pharmacy Details

RITE AID OF NEW YORK, INC.
FQHCLA342 TRILLIUM HEALTH, INC.

Covered Entity Details

Entity Name

TRILLIUM HEALTH, INC.

Subdivision Name

Trillium Health at Monroe Square

Type

Health Center Program Look-Alike

340B ID

FQHCLA342

Entity Address

259 Monroe Avenue Suite 100
Rochester, NY 14607-3632

Grant Number

LALCS00182

Participating Start Date

1/1/2017

Last Recertification Date

2/10/2025

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

Rite Aid
Alison Farrell, Vice President, Managed Care
(717) 975-5968

Signed By Date

4/16/2025

340B Drug Pricing Program Database