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THRIFTY PAYLESS, INC.
CHC26601-00 Full Circle Health, Inc.
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Covered Entity Details
Entity Name
Full Circle Health, Inc.
Subdivision Name
Full Circle Health - Meridian
Type
HRSA-Funded Health Center
340B ID
CHC26601-00
Entity Address
2275 S Eagle Rd STE 120
Meridian, ID 83642-2620
Grant Number
H80CS26601
Participating Start Date
4/1/2014
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5415
10600 FAIRVIEW AVENUE
BOISE, ID 83713
Pharmacy Comments
Contract Details
Approval Date
1/11/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/18/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Tad Arnt, Chief Operating Officer
(208) 514-2500 Ext: 1104
Contract Pharmacy Representative
Family Medicine Residency of Idaho, Inc. (The)
Michelle Robin, Sr. Director, Grant Compliance
(208) 860-7299
Signed By Date
1/11/2022
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