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THRIFTY PAYLESS, INC.
CAH051310-00 Willits Hospital Inc., DBA Adventist Health Howard Memorial
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Covered Entity Details
Entity Name
Willits Hospital Inc., DBA Adventist Health Howard Memorial
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH051310-00
Entity Address
One Marcela Drive
Willits, CA 95490-5769
Medicare Provider Number
051310
Participating Start Date
10/1/2011
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #6034
1730 SOUTH MAIN STREET
WILLITS, CA 95490
Pharmacy Comments
Contract Details
Approval Date
10/28/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen Scott, VP of Patient Care
(707) 456-3010
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
10/28/2016
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