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MORRO BAY DRUG AND GIFT
CH090710 COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
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Covered Entity Details
Entity Name
COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.
Subdivision Name
NIPOMO COMMUNITY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH090710
Entity Address
150 TEJAS PL
NIPOMO, CA 93444-9123
Grant Number
H80CS00621
Participating Start Date
4/1/1996
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
MORRO BAY DRUG AND GIFT
Pharmacy Address
600 MORRO BAY BLVD.
STE. B
MORRO BAY, CA 93442
Pharmacy Comments
Contract Details
Approval Date
9/20/2019
Contract Begin Date
9/20/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/31/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
RONALD E. CASTLE, CEO
(805) 459-1835
Contract Pharmacy Representative
MORRO BAY DRUG & GIFT
SUMANTA PAUL, CEO
(805) 771-9988
Signed By Date
9/20/2019
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