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THRIFTY PAYLESS, INC.
CH093120 FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
Subdivision Name
Logan Heights Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH093120
Entity Address
1809 National Ave
San Diego, CA 92113-2113
Grant Number
H80CS00224
Participating Start Date
12/1/1992
Last Recertification Date
3/1/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5632
9532 WINTER GARDENS BLVD.
LAKESIDE, CA 92040
Pharmacy Comments
Contract Details
Approval Date
7/8/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/28/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Ricardo Roman, CFO
(619) 906-4603
Contract Pharmacy Representative
Rite Aid
Chris Hall, Senior Vice President
(717) 214-8834
Signed By Date
7/8/2013
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