340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MISSION PLAZA PHARMACY
FQHCLA382 LAGUNA BEACH COMMUNITY CLINIC INC
Print
Covered Entity Details
Entity Name
LAGUNA BEACH COMMUNITY CLINIC INC
Subdivision Name
Laguna Beach Community Clinic
Type
Health Center Program Look-Alike
340B ID
FQHCLA382
Entity Address
362 Third Street
Laguna Beach, CA 92651
Grant Number
LALCS32582
Participating Start Date
4/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
MISSION PLAZA PHARMACY
Pharmacy Address
26800 CROWN VALLEY PKWY STE 185
MISSION VIEJO, CA 92691-7304
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
Jorge Rubal, C.E.O. / C.M.O.
(949) 494-0761 Ext: 132
Contract Pharmacy Representative
Advantage HealthCare Services
Vimal Bhanvadia, owner
(949) 364-0122
Signed By Date
10/14/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session