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MADERA MEDICAL PHARMACY
CH09321A Camarena Health
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Covered Entity Details
Entity Name
Camarena Health
Subdivision Name
DMC Family Care Health Center
Type
HRSA-Funded Health Center
340B ID
CH09321A
Entity Address
344 E 6th St
Madera, CA 93638-3631
Grant Number
H80CS00143
Participating Start Date
1/1/2003
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
MADERA MEDICAL PHARMACY
Pharmacy Address
LBN- MEL PHARM INC
402 S. MADERA AVENUE
SUITE A
MADERA, CA 93637
Pharmacy Comments
Contract Details
Approval Date
2/14/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/3/2020
Ownership change
Contacts
Covered Entity Signing Official
Paulo A. Soares, CEO
(559) 664-4089
Contract Pharmacy Representative
Lori Pryce, Pharmacy Manager
(559) 674-8553
Signed By Date
1/22/2013
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