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THRIFTY PAYLESS, INC.
CH095380 Marin Community Clinic
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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 #5963
910 DIABLO AVENUE
NOVATO, CA 94947
Pharmacy Comments
Contract Details
Approval Date
7/16/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/15/2024
Pharmacy closed
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
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