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THRIFTY PAYLESS, INC.
CH091600 Omni Family Health
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Covered Entity Details
Entity Name
Omni Family Health
Subdivision Name
Omni Family Health
Type
HRSA-Funded Health Center
340B ID
CH091600
Entity Address
277 East Front Street
Buttonwillow, CA 93206
Grant Number
H80CS00615
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #6459
1735 E WALNUT AVENUE
VISALIA, CA 93292
Pharmacy Comments
Contract Details
Approval Date
10/8/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/20/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Diego Martinez, Chief Operations Officer
(661) 630-7030
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
10/8/2018
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