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THRIFTY PAYLESS, INC.
CH09208B ALLIANCE MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
ALLIANCE MEDICAL CENTER, INC.
Subdivision Name
Windsor Dental Clinic
Type
HRSA-Funded Health Center
340B ID
CH09208B
Entity Address
8499 Old Redwood Hwy. STE 111 & 112
Windsor, CA 95492
Grant Number
H80CS00249
Participating Start Date
4/1/2017
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
THRIFTY PAYLESS, INC.
Pharmacy Address
RITE AID #6029
525 HEALDSBURG AVENUE
HEALDSBURG, CA 95448
Pharmacy Comments
Contract Details
Approval Date
1/15/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alex Armstrong, CEO
(707) 385-2306
Contract Pharmacy Representative
Rite Aid
Ruth Lightner, Director
(717) 731-6524
Signed By Date
1/15/2018
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