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THRIFTY PAYLESS, INC.
CHC11402-09 NORTHEAST COMMUNITY CLINIC, INC
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Covered Entity Details
Entity Name
NORTHEAST COMMUNITY CLINIC, INC
Subdivision Name
Wilmington Family Health Center
Type
HRSA-Funded Health Center
340B ID
CHC11402-09
Entity Address
200 E Anaheim St
Wilmington, CA 90744-4516
Grant Number
H80CS12869
Participating Start Date
1/1/2010
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5445
4322 SOUTH FIGUEROA STREET
LOS ANGELES, CA 90037
Pharmacy Comments
Contract Details
Approval Date
2/13/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
CHRISTOPHER LAU, EXECUTIVE DIRECTOR
(626) 457-6900
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
2/13/2017
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