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RITE AID OF OHIO, INC.
CH056820 COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC
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Covered Entity Details
Entity Name
COMMUNITY ACTION AGENCY OF COLUMBIANA COUNTY INC
Subdivision Name
DBA LISBON COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH056820
Entity Address
7880 Lincole Pl
Lisbon, OH 44432-8322
Grant Number
H80CS00197
Participating Start Date
7/1/1997
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
RITE AID OF OHIO, INC.
Pharmacy Address
RITE AID #3181
14973 SOUTH AVENUE
COLUMBIANA, OH 44408
Pharmacy Comments
Contract Details
Approval Date
10/3/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/15/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jenna E Wonner, COO
(330) 424-7221 Ext: 103
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
10/3/2013
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