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THRIFTY PAYLESS, INC.
CH101020 Sea Mar Community Health Centers
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Covered Entity Details
Entity Name
Sea Mar Community Health Centers
Subdivision Name
Sea Mar CHC - Administration
Type
HRSA-Funded Health Center
340B ID
CH101020
Entity Address
1040 S. Henderson St.
Seattle, WA 98108
Grant Number
H80CS00445
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5291
13511 SE THIRD WAY
VANCOUVER, WA 98684
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/22/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Mary Bartolo, VP, Deputy Director
(206) 763-5277
Contract Pharmacy Representative
Rite Aid
Lisa Foster, Manager-Pharmacy
(717) 214-2518
Signed By Date
10/15/2019
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