Contract Pharmacy Details

SF GENERAL HOSPITAL MED CEN
CH09107K SF COMMUNITY CLINIC CONSORTIUM

Covered Entity Details

Entity Name

SF COMMUNITY CLINIC CONSORTIUM

Subdivision Name

FAMILY HEALTH CENTER - WARDS 81, 85

Type

HRSA-Funded Health Center

340B ID

CH09107K

Entity Address

995 POTRERO AVE, BLDG 80
SAN FRANCISCO, CA 94110

Grant Number

H80CS00049

Participating Start Date

4/1/2003

Last Recertification Date

2/13/2017

Entity Termination Date

7/1/2017

Pharmacy Details

Pharmacy Name

SF GENERAL HOSPITAL MED CEN

Pharmacy Address

1001 POTRERO AVE
DEPT OF PHARMACY ROOM 1P2
SAN FRANCISCO, CA 94110-3518

Pharmacy Comments

Contract Details

Approval Date

11/28/2012

Contract Begin Date

11/28/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

7/1/2017

Contacts

Covered Entity Signing Official

David Woods, Chief Pharmacy Officer
(628) 206-2332

Contract Pharmacy Representative

Elena Tinloy, Director of Pharmacy, San Francisco General Hospital
(415) 206-6251

Signed By Date

9/18/2012

340B Drug Pricing Program Database