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THRIFTY PAYLESS, INC.
CH092143X Los Angeles Christian Health Centers
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Covered Entity Details
Entity Name
Los Angeles Christian Health Centers
Subdivision Name
Los Angeles Christian Health Centers at Dolores Mission School
Type
HRSA-Funded Health Center
340B ID
CH092143X
Entity Address
170 South Gless Street
Los Angeles, CA 90033
Grant Number
H80CS06674
Participating Start Date
7/1/2017
Last Recertification Date
2/10/2021
Entity Termination Date
4/1/2022
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #5429
500 SOUTH BROADWAY
LOS ANGELES, CA 90013
Pharmacy Comments
Contract Details
Approval Date
10/10/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/19/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Bettina Lewis, Chief Operations Officer
(213) 893-1960
Contract Pharmacy Representative
Los Angeles Christian Health Centers
Kelly Chen, Pharmacy Director
(323) 268-8391
Signed By Date
10/10/2017
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