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THRIFTY PAYLESS, INC.
CH092536AP JWCH Institute, Inc.
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Covered Entity Details
Entity Name
JWCH Institute, Inc.
Subdivision Name
Wesley Health Centers- Palmdale East
Type
HRSA-Funded Health Center
340B ID
CH092536AP
Entity Address
37926 47th St E
Palmdale, CA 93552-3272
Grant Number
H80CS06673
Participating Start Date
5/2/2019
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5840
1356 WEST AVENUE J
LANCASTER, CA 93534
Pharmacy Comments
Contract Details
Approval Date
7/10/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ALVARO BALLESTEROS, EXECUTIVE DIRECTOR
(323) 201-4516 Ext: 3009
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
7/10/2019
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