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THRIFTY PAYLESS, INC.
DSH050039 ENLOE MEDICAL CENTER
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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 #6094
220 WEST EAST AVENUE
CHICO, CA 95926
Pharmacy Comments
Contract Details
Approval Date
7/12/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/12/2025
Business decision by covered entity and/or pharmacy
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
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