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THRIFTY PAYLESS, INC.
DSH500088 PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER
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Covered Entity Details
Entity Name
PUBLIC HOSPITAL DISTRICT NO 1 OF KING COUNTY DBA VALLEY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH500088
Entity Address
400 S 43RD STREET
RENTON, WA 98055-5010
Medicare Provider Number
500088
Participating Start Date
10/4/2005
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5172
1509 AUBURN WAY SOUTH
AUBURN, WA 98002
Pharmacy Comments
Contract Details
Approval Date
10/6/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeannine Grinnell, Vice President of Finance
(425) 228-3440 Ext: 4268
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
10/6/2016
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