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US BIOSERVICES
CH095440 La Maestra Family Clinic, Inc.
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Covered Entity Details
Entity Name
La Maestra Family Clinic, Inc.
Subdivision Name
La Maestra Family clinic
Type
HRSA-Funded Health Center
340B ID
CH095440
Entity Address
4060 Fairmount Ave
San Diego, CA 92105-1608
Grant Number
H80CS00812
Participating Start Date
4/1/2000
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
US BIOSERVICES
Pharmacy Address
PHARM PLUS ACQUISITION, INC.
5100 E HUNTER AVE
SUITE 101
ANAHEIM, CA 92807-2049
Pharmacy Comments
Contract Details
Approval Date
1/15/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ZARA MARSELIAN, CEO
(619) 584-1612 Ext: 3018
Contract Pharmacy Representative
US Bioservices
Nisha Parekh, Pharmacist-in-Charge
(800) 801-1140
Signed By Date
1/15/2019
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