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RX E-FILL SOLUTIONS
CH09879Y SANTA ROSA COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
SANTA ROSA COMMUNITY HEALTH CENTERS
Subdivision Name
Airway Campus
Type
HRSA-Funded Health Center
340B ID
CH09879Y
Entity Address
3883 Airway Drive
Santa Rosa, CA 95403
Grant Number
H80CS00259
Participating Start Date
3/8/2018
Last Recertification Date
2/3/2019
Entity Termination Date
10/1/2019
Pharmacy Details
Pharmacy Name
RX E-FILL SOLUTIONS
Pharmacy Address
CARDINAL HEALTH PHARMACY SERVICES, LLC
27680 AVENUE MENTRY STE 100
VALENCIA, CA 91355
Pharmacy Comments
Contract Details
Approval Date
10/3/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Naomi Fuchs, CEO
(707) 303-3600 Ext: 3111
Contract Pharmacy Representative
Cardinal Health
Naveen Mansukhani, National Operations Director
(732) 328-0515
Signed By Date
10/3/2018
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