Common Contracts

LONG TERM CARE PHARMACY ALLIANCE TRANSITIONAL ASSISTANTCE BENEFIT CARD PROGRAM NON-NETWORK PROVIDER AGREEMENT

Non-Network Provider Agreement • April 30th, 2004 • New York

• Contract Type
  Non-Network Provider Agreement
• Filed
  April 30th, 2004
• Jurisdiction
  New York

This NON-NETWORK PROVIDER AGREEMENT ("Agreement") is entered by and between Long Term Care Pharmacy Alliance, a Delaware limited liability company (“LTCPA”), and