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WILLOW CREEK PHARMACY
CH091540 OPEN DOOR COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
OPEN DOOR COMMUNITY HEALTH CENTERS
Subdivision Name
Arcata Community Health Center
Type
HRSA-Funded Health Center
340B ID
CH091540
Entity Address
1150 Foster Avenue
Arcata, CA 95521-6210
Grant Number
H80CS00225
Participating Start Date
7/1/1996
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
WILLOW CREEK PHARMACY
Pharmacy Address
39050 HIGHWAY 299
PO BOX 112
WILLOW CREEK, CA 95573
Pharmacy Comments
Contract Details
Approval Date
4/24/2019
Contract Begin Date
4/24/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/14/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Bella, CFO
(707) 826-8633 Ext: 5146
Contract Pharmacy Representative
Willow Creek Pharmacy
Steve Jorgenson, Vice President
(530) 629-3144
Signed By Date
4/24/2019
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