340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
THRIFTY PAYLESS, INC.
DSH050121 Adventist Medical Center
Print
Covered Entity Details
Entity Name
Adventist Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH050121
Entity Address
115 mall drive
HANFORD, CA 93230
Medicare Provider Number
050121
Participating Start Date
1/1/2008
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #6243
2500 NORTH 10TH AVENUE
HANFORD, CA 93230
Pharmacy Comments
Contract Details
Approval Date
1/10/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/3/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
David L. Larsen, SR VP CFO
(559) 537-0050
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
1/10/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session