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MOLLISON PHARMACY
CH09312CZ 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
Beach Area Women's Health Center
Type
HRSA-Funded Health Center
340B ID
CH09312CZ
Entity Address
3690 Mission Blvd
San Diego, CA 92109-7368
Grant Number
H80CS00224
Participating Start Date
10/1/2016
Last Recertification Date
3/1/2025
Pharmacy Details
Pharmacy Name
MOLLISON PHARMACY
Pharmacy Address
505 N MOLLISON AVE STE 101A
EL CAJON, CA 92021-6159
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
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
MERCY CARE PHARMACY
Bassam Massaad, Pharmacist/Owner
(760) 294-0014
Signed By Date
10/15/2019
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