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MED SPECIALTY SAI INC., DBA MKT SPECIALT
CH09312CB FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
Subdivision Name
North Park Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH09312CB
Entity Address
3544 30th St
San Diego, CA 92104-4120
Grant Number
H80CS00224
Participating Start Date
1/1/2011
Last Recertification Date
3/1/2025
Pharmacy Details
Pharmacy Name
MED SPECIALTY SAI INC., DBA MKT SPECIALT
Pharmacy Address
4153 UNIVERSITY AVE STE B
SAN DIEGO, CA 92105-1421
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ricardo Roman, CFO
(619) 906-4603
Contract Pharmacy Representative
MED SPECIALTY SAI INC., DBA MKT SPECIALT
Archana Solipuram, President
(908) 247-8160
Signed By Date
10/14/2019
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