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RITE AID OF PENNSYLVANIA, LLC
CH03029G HAMILTON HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
HAMILTON HEALTH CENTER, INC.
Subdivision Name
Union Deposit Family Practice
Type
HRSA-Funded Health Center
340B ID
CH03029G
Entity Address
891 S Arlington Ave
Harrisburg, PA 17109-5004
Grant Number
H80CS00659
Participating Start Date
4/1/2018
Last Recertification Date
2/10/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
RITE AID OF PENNSYLVANIA, LLC
Pharmacy Address
RITE AID #4260
4299 UNION DEPOSIT ROAD
HARRISBURG, PA 17111
Pharmacy Comments
Contract Details
Approval Date
4/15/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
JEANNINE PETERSON, EXECUTIVE DIRECTOR
(717) 230-3910
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
4/15/2018
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