Contract Pharmacy Details

THRIFTY PAYLESS, INC.
CH092536AF JWCH Institute, Inc.

Covered Entity Details

Entity Name

JWCH Institute, Inc.

Subdivision Name

Wesley Health Centers -- Lynwood High School

Type

HRSA-Funded Health Center

340B ID

CH092536AF

Entity Address

12124 Bullis Rd
Ste B104
Lynwood, CA 90262-5106

Grant Number

H80CS06673

Participating Start Date

7/1/2018

Last Recertification Date

2/19/2025

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

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