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ROL'S DELHI DRUG STORE
CH0919630 LIVINGSTON COMMUNITY HEALTH
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Covered Entity Details
Entity Name
LIVINGSTON COMMUNITY HEALTH
Subdivision Name
LIVINGSTON HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0919630
Entity Address
1140 MAIN STREET
LIVINGSTON, CA 95334
Grant Number
H80CS02588
Participating Start Date
1/1/2005
Last Recertification Date
2/5/2020
Entity Termination Date
4/1/2021
Pharmacy Details
Pharmacy Name
ROL'S DELHI DRUG STORE
Pharmacy Address
9724 STEPHENS STREET
DELHI, CA 95315
Pharmacy Comments
Contract Details
Approval Date
2/10/2006
Contract Begin Date
2/10/2006
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/20/2016
Pharmacy closed
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
1/24/2006
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