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RITE AID OF NEW YORK, INC.
FQHCLA344A Tri-County Family Medicine Program, Inc.
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Covered Entity Details
Entity Name
Tri-County Family Medicine Program, Inc.
Subdivision Name
TCFM Nunda
Type
Health Center Program Look-Alike
340B ID
FQHCLA344A
Entity Address
61 N State St
Nunda, NY 14517-9785
Grant Number
LALCS00181
Participating Start Date
1/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RITE AID OF NEW YORK, INC.
Pharmacy Address
RITE AID #686
9519 FOSTER WHEELER ROAD
DANSVILLE, NY 14437
Pharmacy Comments
Contract Details
Approval Date
10/9/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/28/2018
Ownership change
Contacts
Covered Entity Signing Official
Joyce Wheaton, CEO
(585) 335-3416
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
10/9/2017
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