Contract Pharmacy Details

THRIFTY PAYLESS, INC.
CHC24101-00 ADAPT

Covered Entity Details

Entity Name

ADAPT

Subdivision Name

FQHC- Main Winston

Type

HRSA-Funded Health Center

340B ID

CHC24101-00

Entity Address

671 SW Main St
Winston, OR 97496-9660

Grant Number

H80CS24101

Participating Start Date

4/1/2014

Last Recertification Date

2/13/2025

Pharmacy Details

Pharmacy Name

THRIFTY PAYLESS, INC.

Pharmacy Address

RITE AID #5382
444 STEPHENS STREET, S.E.
ROSEBURG, OR 97470

Pharmacy Comments

Contract Details

Approval Date

7/10/2020

Contract Begin Date

10/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

6/8/2023
Pharmacy closed

Contacts

Covered Entity Signing Official

Gregory Brigham, CEO
(541) 672-2691 Ext: 208

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

7/10/2020

340B Drug Pricing Program Database