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SEBASTOPOL FAMILY PHARMACY, INC.
CH09035A WEST COUNTY HEALTH CENTERS, INC.
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Covered Entity Details
Entity Name
WEST COUNTY HEALTH CENTERS, INC.
Subdivision Name
Russian River Health Center #1
Type
HRSA-Funded Health Center
340B ID
CH09035A
Entity Address
16387 First St
GUERNEVILLE, CA 95446
Grant Number
H80CS00242
Participating Start Date
7/1/2003
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SEBASTOPOL FAMILY PHARMACY, INC.
Pharmacy Address
652 PETALUMA AVE STE I1
SEBASTOPOL, CA 95472-4266
Pharmacy Comments
Contract Details
Approval Date
7/10/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARY SZECSEY, CEO
(707) 869-1594
Contract Pharmacy Representative
Sebastopol Family Pharmacy
Amalia Nocola, President
(707) 869-9055
Signed By Date
7/10/2018
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