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RANCHO PUEBLO PHARMACY
CH090720 NORTH COUNTY HEALTH PROJECT, INC
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Covered Entity Details
Entity Name
NORTH COUNTY HEALTH PROJECT, INC
Subdivision Name
TrueCare
Type
HRSA-Funded Health Center
340B ID
CH090720
Entity Address
150 Valpreda Road
San Marcos, CA 92069-2973
Grant Number
H80CS00228
Participating Start Date
12/1/1992
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RANCHO PUEBLO PHARMACY
Pharmacy Address
31515 RANCHO PUEBLO RD
SUITE 105
TEMECULA, CA 92592
Pharmacy Comments
Contract Details
Approval Date
4/13/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/8/2017
Ownership change
Contacts
Covered Entity Signing Official
IRMA COTA, CEO
(760) 736-6755
Contract Pharmacy Representative
Jason Chvat, CEO
(951) 834-5303
Signed By Date
4/13/2016
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