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THRIFTY PAYLESS, INC.
CH09175B MOUNTAIN VALLEYS HEALTH CENTERS
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Covered Entity Details
Entity Name
MOUNTAIN VALLEYS HEALTH CENTERS
Subdivision Name
BUTTE VALLEY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH09175B
Entity Address
610 W. 3RD ST.
DORRIS, CA 96023-0170
Grant Number
H80CS00260
Participating Start Date
4/1/2002
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5388
2521 SOUTH SIXTH STREET
KLAMATH FALLS, OR 97601
Pharmacy Comments
Contract Details
Approval Date
4/2/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DAVE JONES, CEO
(530) 294-5241
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
4/2/2013
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