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THRIFTY PAYLESS, INC.
CH09175G MOUNTAIN VALLEYS HEALTH CENTERS
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Covered Entity Details
Entity Name
MOUNTAIN VALLEYS HEALTH CENTERS
Subdivision Name
MT. SHASTA HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH09175G
Entity Address
101 Old McCloud Rd
Mount Shasta, CA 96067-2796
Grant Number
H80CS00260
Participating Start Date
7/1/2018
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #6103
310 WEST LAKE STREET
MOUNT SHASTA, CA 96067
Pharmacy Comments
Contract Details
Approval Date
4/8/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shannon Gerig, CEO
(530) 999-9010
Contract Pharmacy Representative
CaptureRx
Elsa Perez, Principal Client Relationship Manager
(210) 587-3486 Ext: 115
Signed By Date
4/8/2024
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