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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 #5862
1210 NORTH BLACKSTONE AVENUE
FRESNO, CA 93703
Pharmacy Comments
Contract Details
Approval Date
7/8/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Hayes, Chief medical officer
(661) 630-7039
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
7/8/2019
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