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THRIFTY PAYLESS, INC.
CH092176B WESTERN SIERRA MEDICAL CLINIC INC
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Covered Entity Details
Entity Name
WESTERN SIERRA MEDICAL CLINIC INC
Subdivision Name
Western Sierra Medical Clinic
Type
HRSA-Funded Health Center
340B ID
CH092176B
Entity Address
844 Old Tunnel Rd
Grass Valley, CA 95945-5952
Grant Number
H80CS08234
Participating Start Date
4/1/2010
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #6106
8245 NORTH LAKE BOULEVARD
PO BOX 1175
KINGS BEACH, CA 96143
Pharmacy Comments
Contract Details
Approval Date
12/6/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/1/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Scott McFarland, Chief Executive Officer
(530) 273-4984 Ext: 115
Contract Pharmacy Representative
Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968
Signed By Date
12/6/2017
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