Contract Pharmacy Details

ECKERD CORPORATION
RRC330103-00 Olean General Hospital

Covered Entity Details

Entity Name

Olean General Hospital

Subdivision Name

Type

Rural Referral Center

340B ID

RRC330103-00

Entity Address

515 Main Street
Olean, NY 14760

Medicare Provider Number

330103

Participating Start Date

4/1/2014

Last Recertification Date

8/23/2018

Entity Termination Date

10/1/2019

Pharmacy Details

Pharmacy Name

ECKERD CORPORATION

Pharmacy Address

RITE AID #10885
110 BOLIVAR ROAD
WELLSVILLE, NY 14895

Pharmacy Comments

Contract Details

Approval Date

1/4/2016

Contract Begin Date

4/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2018
Ownership change

Contacts

Covered Entity Signing Official

Richard G. Braun Jr., SVP Finance and CFO
(716) 375-6190

Contract Pharmacy Representative

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

Signed By Date

1/4/2016

340B Drug Pricing Program Database