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THRIFTY PAYLESS, INC.
CH101630 VALLEY FAMILY HEALTH CARE INC
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Covered Entity Details
Entity Name
VALLEY FAMILY HEALTH CARE INC
Subdivision Name
VALLEY FAMILY HEALTH CARE - Payette Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CH101630
Entity Address
1441 NE 10th Ave
Payette, ID 83661-5420
Grant Number
H80CS00556
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5400
728 SOUTH WEST 4TH AVENUE
ONTARIO, OR 97914
Pharmacy Comments
Contract Details
Approval Date
4/11/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Beth Mahoney, Quality Director
(208) 642-7364 Ext: 4504
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President Managed Care
(717) 975-5978
Signed By Date
4/11/2016
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