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THRIFTY PAYLESS, INC.
CH09365A CLINICAS DEL CAMINO REAL, INC.
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Covered Entity Details
Entity Name
CLINICAS DEL CAMINO REAL, INC.
Subdivision Name
Clinicas Del Camino Real Inc - Fillmore
Type
HRSA-Funded Health Center
340B ID
CH09365A
Entity Address
355 Central Ave
Fillmore, CA 93015-1920
Grant Number
H80CS00550
Participating Start Date
7/1/1995
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5779
11496 NORTH VENTURA AVE.
OJAI (MIRA MONTE), CA 93023
Pharmacy Comments
Contract Details
Approval Date
10/10/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Streeter, Chief Medical Officer
(805) 659-1740
Contract Pharmacy Representative
Rite Aid
Owen McMahon, GVP, Enterprise Pharmaceutical Purchasing
(717) 214-2505
Signed By Date
10/10/2023
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