340B Drug Pricing Program Database
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EDC DRUG STORES, INC.
DSH340069 WAKEMED
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Covered Entity Details
Entity Name
WAKEMED
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340069
Entity Address
3000 NEW BERN AVENUE
RALEIGH, NC 27610
Medicare Provider Number
340069
Participating Start Date
1/1/2016
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
EDC DRUG STORES, INC.
Pharmacy Address
RITE AID #11369
11360 US HIGHWAY 70 WEST
CLAYTON, NC 27520
Pharmacy Comments
Contract Details
Approval Date
7/13/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/8/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mike Browning, Executive VP of Finance, CFO
(919) 350-8118
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
7/13/2016
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