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ALBERTSONS LLC
CH09312CX 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
Spring Valley Family Counseling Center
Type
HRSA-Funded Health Center
340B ID
CH09312CX
Entity Address
3845 Spring Dr.
Spring Valley, CA 91977-1030
Grant Number
H80CS00224
Participating Start Date
10/1/2016
Last Recertification Date
3/1/2025
Pharmacy Details
Pharmacy Name
ALBERTSONS LLC
Pharmacy Address
SAV-ON PHARMACY #3202
1608 BROADWAY
EL CAJON, CA 92021
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
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
10/15/2019
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