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ECKERD CORPORATION
FQHCLA344 Tri-County Family Medicine Program, Inc.
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Covered Entity Details
Entity Name
Tri-County Family Medicine Program, Inc.
Subdivision Name
Tri-County Family Medicine Program, Inc. - Admin
Type
Health Center Program Look-Alike
340B ID
FQHCLA344
Entity Address
10869 State Route 36
Dansville, NY 14437-0601
Grant Number
LALCS00181
Participating Start Date
1/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
ECKERD CORPORATION
Pharmacy Address
RITE AID #10879
12 PARK DRIVE
HORNELL, NY 14843
Pharmacy Comments
Contract Details
Approval Date
10/10/2017
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
10/10/2017
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