340B Drug Pricing Program Database

Pharmacy Name

THRIFTY PAYLESS, INC.

Pharmacy Address

RITE AID #6105
1615 MAIN STREET
SUSANVILLE, CA 96130

Pharmacy Comments

Approval Date

2/15/2013

Contract Begin Date

4/1/2013

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/18/2016
Business decision by covered entity and/or pharmacy

Covered Entity Signing Official

Dave Kaubisch, Vice President of Finance
(602) 747-4556

Contract Pharmacy Representative

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

Signed By Date

1/11/2013