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RITE AID OF DELAWARE, INC.
DSH080004 BAYHEALTH MEDICAL CENTER INC.
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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 #4924
17069 SOUTH DUPONT HIGHWAY
HARRINGTON, DE 19952
Pharmacy Comments
Contract Details
Approval Date
1/17/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
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
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