340B Drug Pricing Program Database

Pharmacy Name

RITE AID OF NEW HAMPSHIRE, INC.

Pharmacy Address

RITE AID #4155
6 SOUTH MAIN STREET
PLYMOUTH, NH 03264

Pharmacy Comments

Approval Date

12/4/2012

Contract Begin Date

1/1/2013

Carve-In Effective Date

Contract Comments

Covered Entity Signing Official

Crystal Cascadden, Pharmacy Director
(603) 238-2226 Ext: 385

Contract Pharmacy Representative

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

Signed By Date

10/4/2012