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THRIFTY PAYLESS, INC.
CH101310 CLACKAMAS, COUNTY OF
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Covered Entity Details
Entity Name
CLACKAMAS, COUNTY OF
Subdivision Name
Clackamas Health Centers Administration
Type
HRSA-Funded Health Center
340B ID
CH101310
Entity Address
2051 Kaen Road STE 367
Oregon City, OR 97045-4035
Grant Number
H80CS00547
Participating Start Date
4/1/2004
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5359
11930 SE DIVISION STREET
PORTLAND, OR 97266
Pharmacy Comments
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Deborah Cockrell, FQHC Director
(503) 742-5495
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
1/15/2020
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