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MISSION PLAZA PHARMACY
FQHCLA347 FAMILIES TOGETHER OF ORANGE COUNTY
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Covered Entity Details
Entity Name
FAMILIES TOGETHER OF ORANGE COUNTY
Subdivision Name
Families Together of Orange County
Type
Health Center Program Look-Alike
340B ID
FQHCLA347
Entity Address
661 W. 1st St., Ste. G
Tustin, CA 92780
Grant Number
LALCS00186
Participating Start Date
4/1/2017
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
MISSION PLAZA PHARMACY
Pharmacy Address
26800 CROWN VALLEY PKWY STE 185
MISSION VIEJO, CA 92691-7304
Pharmacy Comments
Contract Details
Approval Date
1/10/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Alexander Rossel, CEO
(714) 665-9890
Contract Pharmacy Representative
Mission Plaza Pharmacy
Kinjal Patel, Director
(949) 364-9009
Signed By Date
1/10/2020
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