Contract Pharmacy Details

THRIFTY PAYLESS, INC.
DSH050039 ENLOE MEDICAL CENTER

Covered Entity Details

Entity Name

ENLOE MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH050039

Entity Address

1531 ESPLANADE
CHICO, CA 95926

Medicare Provider Number

050039

Participating Start Date

1/1/2017

Last Recertification Date

9/3/2024

Pharmacy Details

Pharmacy Name

THRIFTY PAYLESS, INC.

Pharmacy Address

RITE AID #6188
640 EDITH AVENUE
CORNING, CA 96021

Pharmacy Comments

Contract Details

Approval Date

7/12/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Kevin Woodward, VP/Chief Financial Officer
(530) 332-6733

Contract Pharmacy Representative

RiteAid
Mark Thorn, Manager, Pharmacy Replenishment Program
(734) 347-1086

Signed By Date

7/12/2021

340B Drug Pricing Program Database