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RITE AID OF PENNSYLVANIA, LLC
CH031839C Esperanza Health Center, Inc.
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Covered Entity Details
Entity Name
Esperanza Health Center, Inc.
Subdivision Name
Esperanza Health Center
Type
HRSA-Funded Health Center
340B ID
CH031839C
Entity Address
4417 N 6th St
Philadelphia, PA 19140-2319
Grant Number
H80CS06644
Participating Start Date
10/1/2011
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #4932
260 WEST LEHIGH AVENUE #80
PHILADELPHIA, PA 19133
Pharmacy Comments
Contract Details
Approval Date
4/12/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard Rohrer, COO
(215) 807-8616
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
4/12/2013
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