Contract Pharmacy Details

THRIFTY PAYLESS, INC.
CHC28357-01 North Olympic Healthcare Network PC

Covered Entity Details

Entity Name

North Olympic Healthcare Network PC

Subdivision Name

North Olympic Healthcare Network First Street

Type

HRSA-Funded Health Center

340B ID

CHC28357-01

Entity Address

933 E. 1st Street
Port Angeles, WA 98362-4012

Grant Number

H80CS28357

Participating Start Date

10/1/2018

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

THRIFTY PAYLESS, INC.

Pharmacy Address

RITE AID #5257
621 SOUTH LINCOLN ST.
PORT ANGELES, WA 98362

Pharmacy Comments

Contract Details

Approval Date

1/16/2024

Contract Begin Date

4/1/2024

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Beau Jacob Brown, Chief Financial Officer
(360) 452-7891 Ext: 2828

Contract Pharmacy Representative

RiteAid
Mark Thorn, Manager, Pharmacy Replenishment Program
(734) 347-1086

Signed By Date

1/16/2024

340B Drug Pricing Program Database