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THRIFTY PAYLESS, INC.
DSH500088 PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER
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Covered Entity Details
Entity Name
PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500088
Entity Address
400 S 43RD STREET
RENTON, WA 98055-5010
Medicare Provider Number
500088
Participating Start Date
10/4/2005
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5185
232 ROOSEVELT AVENUE
ENUMCLAW, WA 98022
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/4/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Jeannine Grinnell, Chief Executive and Financial Officer
(425) 690-3310
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
1/15/2021
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