Contract Pharmacy Details

THRIFTY PAYLESS, INC.
CHC30722-00 UNIVERSAL COMMUNITY HEALTH CENTER

Covered Entity Details

Entity Name

UNIVERSAL COMMUNITY HEALTH CENTER

Subdivision Name

Universal Community Health Center- Washington

Type

HRSA-Funded Health Center

340B ID

CHC30722-00

Entity Address

1005 E. Washington Blvd.
Los Angeles, CA 90021

Grant Number

H80CS30722

Participating Start Date

5/16/2019

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

THRIFTY PAYLESS, INC.

Pharmacy Address

RITE AID #5445
4322 SOUTH FIGUEROA STREET
LOS ANGELES, CA 90037

Pharmacy Comments

Contract Details

Approval Date

7/14/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Edgar Alexander Chavez, CEO
(323) 485-0467

Contract Pharmacy Representative

Rite Aid
Owen McMahon, GVP, Enterprise Pharmaceutical Purchasing
(717) 214-2505

Signed By Date

7/14/2023

340B Drug Pricing Program Database