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RITE AID OF OHIO, INC.
CH051660 IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION
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Covered Entity Details
Entity Name
IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION
Subdivision Name
IRONTON FAMILY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH051660
Entity Address
304 N 2ND ST
IRONTON, OH 45638-1491
Grant Number
H80CS00471
Participating Start Date
10/1/1996
Last Recertification Date
1/31/2017
Entity Termination Date
4/1/2017
Pharmacy Details
Pharmacy Name
RITE AID OF OHIO, INC.
Pharmacy Address
RITE AID #4809
715 PARK AVENUE
IRONTON, OH 45638
Pharmacy Comments
Contract Details
Approval Date
9/7/2012
Contract Begin Date
9/7/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2017
Contacts
Covered Entity Signing Official
Nancy Lewis, Dir. of Health Services
(740) 532-3534
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
8/22/2012
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