Contract Pharmacy Details

THRIFTY PAYLESS, INC.
CH095380 Marin Community Clinic

Covered Entity Details

Entity Name

Marin Community Clinic

Subdivision Name

Marin Community Clinic - Larkspur

Type

HRSA-Funded Health Center

340B ID

CH095380

Entity Address

5 Bon Air Road, Suite 117
Larkspur, CA 94939-1138

Grant Number

H80CS00343

Participating Start Date

10/1/2001

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

THRIFTY PAYLESS, INC.

Pharmacy Address

RITE AID #5958
1500 NORTHGATE MALL
SAN RAFAEL, CA 94903

Pharmacy Comments

Contract Details

Approval Date

7/16/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Mitesh Popat, CEO
(415) 755-2581

Contract Pharmacy Representative

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

Signed By Date

7/16/2018

340B Drug Pricing Program Database