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ENBORG LANE PHARMACY
STD951121 COUNTY OF SANTA CLARA
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Covered Entity Details
Entity Name
COUNTY OF SANTA CLARA
Subdivision Name
CRANE CENTER
Type
Sexually Transmitted Diseases
340B ID
STD951121
Entity Address
976 LENZEN AVENUE
SAN JOSE, CA 95126
Grant Number
1H25PS005127
Participating Start Date
4/1/2003
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
ENBORG LANE PHARMACY
Pharmacy Address
2221 ENBORG LANE
1J018
SAN JOSE, CA 95128
Pharmacy Comments
Contract Details
Approval Date
4/15/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/30/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jim McPherson, STD/HIV Program Manager
(408) 792-5032
Contract Pharmacy Representative
SCVMC
Narinder Singh, Director of Pharmacy
(408) 885-2300
Signed By Date
4/15/2017
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