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ECKERD CORPORATION
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
ECKERD CORPORATION
Pharmacy Address
RITE AID #11401
7505 LOUISBURG ROAD.
RALEIGH, NC 27616
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
2/14/2018
Ownership change
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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