Contract Pharmacy Details

RITE AID OF KENTUCKY, INC.
CH0452880 TRIAD HEALTH SYSTEM INC

Covered Entity Details

Entity Name

TRIAD HEALTH SYSTEM INC

Subdivision Name

TRIAD HEALTH SYSTEMS CHC

Type

HRSA-Funded Health Center

340B ID

CH0452880

Entity Address

441 US Highway 42 West
Warsaw, KY 41095-9323

Grant Number

H80CS08785

Participating Start Date

7/1/2008

Last Recertification Date

2/25/2025

Pharmacy Details

Pharmacy Name

RITE AID OF KENTUCKY, INC.

Pharmacy Address

RITE AID #3936
204 PARK AVENUE
CARROLLTON, KY 41008

Pharmacy Comments

Contract Details

Approval Date

7/17/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/13/2018
Ownership change

Contacts

Covered Entity Signing Official

ADAM CRAFT, EXECUTIVE DIRECTOR
(859) 567-1271

Contract Pharmacy Representative

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

Signed By Date

7/17/2017

340B Drug Pricing Program Database