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THRIFTY PAYLESS, INC.
CHC28357-02 North Olympic Healthcare Network PC
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Covered Entity Details
Entity Name
North Olympic Healthcare Network PC
Subdivision Name
North Olympic Healthcare Network Mobile Clinic
Type
HRSA-Funded Health Center
340B ID
CHC28357-02
Entity Address
933 E 1st St
Port Angeles, WA 98362-4012
Grant Number
H80CS28357
Participating Start Date
4/1/2022
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
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