Contract Pharmacy Details

THRIFTY PAYLESS, INC.
FQHCLA048 County of Tulare

Covered Entity Details

Entity Name

County of Tulare

Subdivision Name

Tulare County Health Services

Type

Health Center Program Look-Alike

340B ID

FQHCLA048

Entity Address

5957 S. Mooney Blvd
Visalia, CA 93277

Grant Number

LALCS00070

Participating Start Date

7/1/1996

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

THRIFTY PAYLESS, INC.

Pharmacy Address

RITE AID #5795
1051 W VISALIA RD
EXETER, CA 93221

Pharmacy Comments

Contract Details

Approval Date

7/14/2014

Contract Begin Date

10/1/2014

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

JASON T. BRITT, DIRECTOR OF PUBLIC HEALTH
(559) 624-8481

Contract Pharmacy Representative

Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217

Signed By Date

7/14/2014

340B Drug Pricing Program Database