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AHF PHARMACY
CH091670 VISTA COMMUNITY CLINIC
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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
AHF PHARMACY
Pharmacy Address
AIDS HEALTHCARE FOUNDATION
4630 BORDER VILLAGE RD STE K
SAN YSIDRO, CA 92173-3121
Pharmacy Comments
Contract Details
Approval Date
12/30/2020
Contract Begin Date
12/31/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Michele Lambert, CFO
(760) 216-5803
Contract Pharmacy Representative
AIDS HEALTHCARE FOUNDATION
Peter Reis, Senior Vice President
(323) 860-5208
Signed By Date
12/30/2020
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