340B Drug Pricing Program Database
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THRIFTY PAYLESS, INC.
RWI921010 Christie's Place, Inc.
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Covered Entity Details
Entity Name
Christie's Place, Inc.
Subdivision Name
Type
Ryan White Part A
340B ID
RWI921010
Entity Address
2440 Third Avenue
San Diego, CA 92101
Grant Number
H89HA00001
Participating Start Date
4/1/2020
Last Recertification Date
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5653
5270 BALBOA AVENUE
SAN DIEGO, CA 92117
Pharmacy Comments
Contract Details
Approval Date
3/10/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/28/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Rhea Van Brocklin, Executive Director
(619) 702-4186 Ext: 6197024186
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
3/10/2020
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