Contract Pharmacy Details

ALLEN PHARMACY
CH0933070 ST. VINCENT DE PAUL VILLAGE, INC.

Covered Entity Details

Entity Name

ST. VINCENT DE PAUL VILLAGE, INC.

Subdivision Name

Village Health Center

Type

HRSA-Funded Health Center

340B ID

CH0933070

Entity Address

16 15th St
San Diego, CA 92101

Grant Number

H80CS10606

Participating Start Date

9/5/2008

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

ALLEN PHARMACY

Pharmacy Address

333 C ST STE 100
SAN DIEGO, CA 92101-5203

Pharmacy Comments

Contract Details

Approval Date

4/8/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/25/2024
Ownership change

Contacts

Covered Entity Signing Official

Jeffrey Norris, CMO
(619) 645-6422

Contract Pharmacy Representative

Allen Pharmacy
Aram Penaranda, CFO
(619) 232-8101

Signed By Date

4/8/2020