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SCVH&HS REFILL CTR PHARMACY
CH091181H SANTA CLARA, COUNTY OF
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Covered Entity Details
Entity Name
SANTA CLARA, COUNTY OF
Subdivision Name
Valley Health Center San Jose
Type
HRSA-Funded Health Center
340B ID
CH091181H
Entity Address
750 S. BASCOM AVE
SAN JOSE, CA 95128-2603
Grant Number
H80CS01442
Participating Start Date
7/1/2001
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
SCVH&HS REFILL CTR PHARMACY
Pharmacy Address
871 ENBORG COURT
UNIT 200
SAN JOSE, CA 95128
Pharmacy Comments
Contract Details
Approval Date
4/30/2010
Contract Begin Date
5/1/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/6/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
4/9/2010
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