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IMGRX HEALDSBURG, INC. DBA
CH092080 ALLIANCE MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
ALLIANCE MEDICAL CENTER, INC.
Subdivision Name
ALLIANCE MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH092080
Entity Address
1381 UNIVERSITY AVENUE
HEALDSBURG, CA 95448-3314
Grant Number
H80CS00249
Participating Start Date
4/1/1996
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
IMGRX HEALDSBURG, INC. DBA
Pharmacy Address
AMC COMMUNITY PHARMACY
1381 UNIVERSITY STREET, SUITE A
HEALDSBURG, CA 95448
Pharmacy Comments
Contract Details
Approval Date
1/14/2019
Contract Begin Date
1/14/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Alex Armstrong, CEO
(707) 385-2306
Contract Pharmacy Representative
Cardinal Health
Naveen Mansukhani, National Operations Director
(732) 328-0515
Signed By Date
1/14/2019
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