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RITE AID OF NEW YORK, INC.
CHC08760-00 WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CHC08760-00
Entity Address
600 Maple Ave
6
HONESDALE, PA 18431
Grant Number
H80CS08760
Participating Start Date
1/1/2010
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #2749
119 WEST MAIN STREET
HANCOCK, NY 13783
Pharmacy Comments
Contract Details
Approval Date
1/11/2016
Contract Begin Date
4/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/13/2018
Ownership change
Contacts
Covered Entity Signing Official
Frederick Jackson, Executive Director
(570) 253-8450
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President Managed Care
(717) 214-8538
Signed By Date
1/11/2016
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