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RITE AID OF NEW YORK, INC.
DSH330115 ONEIDA HEALTHCARE CENTER
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Covered Entity Details
Entity Name
ONEIDA HEALTHCARE CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH330115
Entity Address
321 GENESEE STREET
ONEIDA, NY 13421
Medicare Provider Number
330115
Participating Start Date
1/1/2015
Last Recertification Date
8/23/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #755
104 GENESEE STREET
ONEIDA, NY 13421
Pharmacy Comments
Contract Details
Approval Date
1/14/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/3/2018
Ownership change
Contacts
Covered Entity Signing Official
John Milligan, CFO
(315) 361-2088
Contract Pharmacy Representative
Rite Aid
Chris Hall, Senior Vice President
(717) 214-8834
Signed By Date
1/14/2015
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