Contract Pharmacy Details

RITE AID OF DELAWARE, INC.
DSH080004 BAYHEALTH MEDICAL CENTER INC.

Covered Entity Details

Entity Name

BAYHEALTH MEDICAL CENTER INC.

Subdivision Name

KENT GENERAL HOSPITAL

Type

Disproportionate Share Hospital

340B ID

DSH080004

Entity Address

640 SOUTH STATE STREET
DOVER, DE 19901-3597

Medicare Provider Number

080004

Participating Start Date

4/1/2009

Last Recertification Date

8/22/2024

Pharmacy Details

Pharmacy Name

RITE AID OF DELAWARE, INC.

Pharmacy Address

RITE AID #3749
677 NORTH DUPONT BLVD
MILFORD, DE 19963

Pharmacy Comments

Contract Details

Approval Date

1/17/2017

Contract Begin Date

4/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/30/2018
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Michael James Tretina, CFO
(302) 744-7162

Contract Pharmacy Representative

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

Signed By Date

1/17/2017

340B Drug Pricing Program Database