Contract Pharmacy Details

ALBERTSONS LLC
CH099010 BORREGO COMMUNITY HEALTH FOUNDATION

Covered Entity Details

Entity Name

BORREGO COMMUNITY HEALTH FOUNDATION

Subdivision Name

BORREGO COMMUNITY HEALTH FOUNDATION

Type

HRSA-Funded Health Center

340B ID

CH099010

Entity Address

4343 YAQUI PASS ROAD
BORREGO SPRINGS, CA 92004-2369

Grant Number

H80CS00287

Participating Start Date

1/1/2003

Last Recertification Date

2/13/2023

Entity Termination Date

4/1/2024

Pharmacy Details

Pharmacy Name

ALBERTSONS LLC

Pharmacy Address

SAV-ON PHARMACY #2586
40101 MONTEREY AVE
RANCHO MIRAGE, CA 92270

Pharmacy Comments

Contract Details

Approval Date

4/12/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2024
Covered Entity Terminated

Contacts

Covered Entity Signing Official

BRUCE HEBETS, CEO
(760) 767-6433

Contract Pharmacy Representative

Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304

Signed By Date

4/12/2017

340B Drug Pricing Program Database