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RITE AID OF OHIO, INC.
CH050990 HEALTHSOURCE OF OHIO, INC.
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Covered Entity Details
Entity Name
HEALTHSOURCE OF OHIO, INC.
Subdivision Name
HEALTHSOURCE OF OHIO, INC.
Type
HRSA-Funded Health Center
340B ID
CH050990
Entity Address
424 WARDS CORNER STE 200
LOVELAND, OH 45140-6966
Grant Number
H80CS00201
Participating Start Date
10/1/1998
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
RITE AID OF OHIO, INC.
Pharmacy Address
RITE AID #3466
109 JEFFERSON STREET
GREENFIELD, OH 45123
Pharmacy Comments
Contract Details
Approval Date
4/2/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/15/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Kim Patton, President
(513) 576-7700 Ext: 3606
Contract Pharmacy Representative
PDS I Michigan, Inc
Allison Farrell, Senior Vice President
(717) 214-8834
Signed By Date
4/2/2015
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