Contract Pharmacy Details

RITE AID OF PENNSYLVANIA, LLC
CH031670 PUBLIC HEALTH MANAGEMENT CORPORATION

Covered Entity Details

Entity Name

PUBLIC HEALTH MANAGEMENT CORPORATION

Subdivision Name

Public Health Management Corporation

Type

HRSA-Funded Health Center

340B ID

CH031670

Entity Address

Centre Square East
1500 Market Street
Philadelphia, PA 19102-2100

Grant Number

H80CS00016

Participating Start Date

7/1/2004

Last Recertification Date

2/28/2025

Pharmacy Details

Pharmacy Name

RITE AID OF PENNSYLVANIA, LLC

Pharmacy Address

RITE AID #4932
260 WEST LEHIGH AVENUE #80
PHILADELPHIA, PA 19133

Pharmacy Comments

Contract Details

Approval Date

4/3/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Richard Cohen, President and CEO
(215) 985-2501

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

4/3/2018

340B Drug Pricing Program Database