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LARK REXALL DRUGS INC
CH09879W SANTA ROSA COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
SANTA ROSA COMMUNITY HEALTH CENTERS
Subdivision Name
Van #1 (Tiburcio)
Type
HRSA-Funded Health Center
340B ID
CH09879W
Entity Address
1110 N Dutton Ave
Santa Rosa, CA 95401-4606
Grant Number
H80CS00259
Participating Start Date
7/1/2020
Last Recertification Date
2/3/2022
Entity Termination Date
4/1/2023
Pharmacy Details
Pharmacy Name
LARK REXALL DRUGS INC
Pharmacy Address
DBA LARK DRUGS PHARMACY
16251 MAIN ST
GUERNEVILLE, CA 95446-8300
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Naomi Fuchs, CEO
(707) 303-3600 Ext: 3111
Contract Pharmacy Representative
Santa Rose Community Centers
Amalia Nicola, President
(707) 869-9055
Signed By Date
4/14/2020
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