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THRIFTY PAYLESS, INC.
CH092536A JWCH INSTITUTE, INC.
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Covered Entity Details
Entity Name
JWCH INSTITUTE, INC.
Subdivision Name
JWCH MEDICAL CLINIC @ WEINGART
Type
HRSA-Funded Health Center
340B ID
CH092536A
Entity Address
515 E 6th St
Los Angeles, CA 90021-1009
Grant Number
H80CS06673
Participating Start Date
9/16/2005
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5429
500 SOUTH BROADWAY
LOS ANGELES, CA 90013
Pharmacy Comments
Contract Details
Approval Date
7/14/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/1/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
ALVARO BALLESTEROS, EXECUTIVE DIRECTOR
(323) 201-4516 Ext: 3009
Contract Pharmacy Representative
Rite Aid
Jennifer Zorek, contact
(717) 975-5937
Signed By Date
7/14/2021
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