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THRIFTY PAYLESS, INC.
CH101000 MOSES LAKE COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
MOSES LAKE COMMUNITY HEALTH CENTER
Subdivision Name
MOSES LAKE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH101000
Entity Address
605 S Coolidge St
Moses Lake, WA 98837
Grant Number
H80CS00702
Participating Start Date
1/1/2000
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5293
500 SOUTH PIONEER WAY
MOSES LAKE, WA 98837
Pharmacy Comments
Contract Details
Approval Date
7/10/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Sheila Berschauer, CEO
(509) 765-0674 Ext: 2411
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
7/10/2013
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