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MADERA MEDICAL PHARMACY
CH093210 Camarena Health
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Covered Entity Details
Entity Name
Camarena Health
Subdivision Name
DMC WOMEN'S CARE HEALTH CTR
Type
HRSA-Funded Health Center
340B ID
CH093210
Entity Address
201 S B St
Madera, CA 93638-3719
Grant Number
H80CS00143
Participating Start Date
4/1/2001
Last Recertification Date
1/31/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
MADERA MEDICAL PHARMACY
Pharmacy Address
LBN- MEL PHARM INC
402 S. MADERA AVENUE
SUITE A
MADERA, CA 93637
Pharmacy Comments
Contract Details
Approval Date
5/16/2011
Contract Begin Date
5/24/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/3/2020
Ownership change
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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