Contract Pharmacy Details

RITE AID OF NEW YORK, INC.
FQHCLA344E Tri-County Family Medicine Program, Inc.

Covered Entity Details

Entity Name

Tri-County Family Medicine Program, Inc.

Subdivision Name

TCFM Wayland

Type

Health Center Program Look-Alike

340B ID

FQHCLA344E

Entity Address

200 N Main St
Wayland, NY 14572-1034

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 #3983
338 WEST WASHINGTON STREET
BATH, NY 14810

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

7/31/2023
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Joyce Wheaton, CEO
(585) 335-3416

Contract Pharmacy Representative

RiteAid
Mark Thorn, Manager, Pharmacy Replenishment Program
(734) 347-1086

Signed By Date

10/9/2017

340B Drug Pricing Program Database