Contract Pharmacy Details

THRIFTY PAYLESS, INC.
CH092536S JWCH INSTITUTE, INC.

Covered Entity Details

Entity Name

JWCH INSTITUTE, INC.

Subdivision Name

JWCH Medical Clinic @ Bell Shelter

Type

HRSA-Funded Health Center

340B ID

CH092536S

Entity Address

5600 Rickenbacker Road, Bldg. E-1
Bell, CA 90201

Grant Number

H80CS06673

Participating Start Date

1/1/2015

Last Recertification Date

2/15/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

THRIFTY PAYLESS, INC.

Pharmacy Address

RITE AID #5476
11325 LONG BEACH BOULEVARD
LYNWOOD, CA 90262

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

4/1/2024
Covered Entity Terminated

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

340B Drug Pricing Program Database