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THRIFTY PAYLESS, INC.
CH0910250 MENDOCINO COAST CLINICS, INC.
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Covered Entity Details
Entity Name
MENDOCINO COAST CLINICS, INC.
Subdivision Name
MENDOCINO COAST CLINICS, INC.
Type
HRSA-Funded Health Center
340B ID
CH0910250
Entity Address
205 South St
Fort Bragg, CA 95437-5540
Grant Number
H80CS00876
Participating Start Date
1/1/2001
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #6033
680 SOUTH STATE STREET
UKIAH, CA 95482
Pharmacy Comments
Contract Details
Approval Date
4/18/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/26/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Lucresha Renteria, Executive Director
(707) 964-1251 Ext: 3433
Contract Pharmacy Representative
Rite Aid
Owen McMahon, GVP, Enterprise Pharmaceutical Purchasing
(717) 214-2505
Signed By Date
4/18/2024
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