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PHARMEDQUEST PHARMACY SERVICES
CH09538B MARIN COMMUNITY CLINIC
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Covered Entity Details
Entity Name
MARIN COMMUNITY CLINIC
Subdivision Name
Marin Community Clinic - San Rafael
Type
HRSA-Funded Health Center
340B ID
CH09538B
Entity Address
3110 KERNER BLVD
SAN RAFAEL, CA 94901
Grant Number
H80CS00343
Participating Start Date
1/1/2010
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
PHARMEDQUEST PHARMACY SERVICES
Pharmacy Address
451 W LAMBERT RD STE 208
BREA, CA 92821-3920
Pharmacy Comments
10/17/2013- updated pharmacy name/address (was PharMed Quest Pharmacy Services Inc., dba Watts Clinic Pharmacy 471 W. LAMBERT ROAD STE 111)
Contract Details
Approval Date
4/3/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/8/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mitesh Popat, CEO
(415) 755-2581
Contract Pharmacy Representative
PharMedQuest
Meera Hasolkar, Director of Pharmacy Operations
(714) 364-4008
Signed By Date
4/3/2019
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