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RITE AID OF OHIO, INC.
CHC30718-01 SIGNATURE HEALTH, INC.
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Covered Entity Details
Entity Name
SIGNATURE HEALTH, INC.
Subdivision Name
Signature Health, Inc. Painesville Clinic
Type
HRSA-Funded Health Center
340B ID
CHC30718-01
Entity Address
54 S. State St
Painesville, OH 44077
Grant Number
H80CS30718
Participating Start Date
4/1/2017
Last Recertification Date
2/22/2025
Pharmacy Details
Pharmacy Name
RITE AID OF OHIO, INC.
Pharmacy Address
RITE AID #3195
180 NORTH STATE STREET
PAINESVILLE, OH 44077
Pharmacy Comments
Contract Details
Approval Date
1/15/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/14/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jonathan Albert Lee, CEO
(440) 953-9999 Ext: 705133
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
1/15/2018
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