Contract Pharmacy Details

AMAZON PHARMACY #001
CH091670 VISTA COMMUNITY CLINIC

Covered Entity Details

Entity Name

VISTA COMMUNITY CLINIC

Subdivision Name

VCC: VALE TERRACE

Type

HRSA-Funded Health Center

340B ID

CH091670

Entity Address

1000 Vale Terrace Dr.
Vista, CA 92084-5218

Grant Number

H80CS00282

Participating Start Date

4/1/1996

Last Recertification Date

2/19/2025

Pharmacy Details

Pharmacy Name

AMAZON PHARMACY #001

Pharmacy Address

4500 S PLEASANT VALLEY RD STE 201
AUSTIN, TX 78744-2911

Pharmacy Comments

Contract Details

Approval Date

1/14/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/31/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Michele Lambert, CFO
(760) 216-5803

Contract Pharmacy Representative

PillPack, Inc.
Geoff Swindle, Administrator
(855) 745-5725

Signed By Date

1/14/2020

340B Drug Pricing Program Database