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THRIFTY PAYLESS, INC.
CH09167G VISTA COMMUNITY CLINIC
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Covered Entity Details
Entity Name
VISTA COMMUNITY CLINIC
Subdivision Name
VCC: Lake Elsinore
Type
HRSA-Funded Health Center
340B ID
CH09167G
Entity Address
30195 FRASER DR
LAKE ELSINORE, CA 92530-7006
Grant Number
H80CS00282
Participating Start Date
4/1/2016
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5635
3813 PLAZA DRIVE
OCEANSIDE, CA 92056
Pharmacy Comments
Contract Details
Approval Date
7/12/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/24/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Michele Lambert, CFO
(760) 216-5803
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
7/12/2023
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