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THRIFTY PAYLESS, INC.
CHC24112-01 MCCLOUD HEALTHCARE CLINIC INC
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Covered Entity Details
Entity Name
MCCLOUD HEALTHCARE CLINIC INC
Subdivision Name
Shasta Cascade Health Centers - Dunsmuir
Type
HRSA-Funded Health Center
340B ID
CHC24112-01
Entity Address
4309 Stagecoach Rd
Dunsmuir, CA 96025-1812
Grant Number
H80CS24112
Participating Start Date
1/1/2014
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #6103
310 WEST LAKE STREET
MOUNT SHASTA, CA 96067
Pharmacy Comments
Contract Details
Approval Date
10/12/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/4/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Sumner Proffitt, CEO
(530) 964-2389
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
10/12/2017
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