Contract Pharmacy Details

ANCHOR DRUGS
CH09114E SAN MATEO MEDICAL CENTER

Covered Entity Details

Entity Name

SAN MATEO MEDICAL CENTER

Subdivision Name

SEQUOIA TEEN WELLNESS

Type

HRSA-Funded Health Center

340B ID

CH09114E

Entity Address

630 LAUREL STREET
REDWOOD CITY, CA 94063

Grant Number

H80CS00051

Participating Start Date

1/1/2005

Last Recertification Date

2/5/2021

Entity Termination Date

4/1/2022

Pharmacy Details

Pharmacy Name

ANCHOR DRUGS

Pharmacy Address

161 S SPRUCE AVE
SOUTH SAN FRANCISCO, CA 94080

Pharmacy Comments

Contract Details

Approval Date

4/12/2012

Contract Begin Date

4/12/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2022
Covered Entity Terminated

Contacts

Covered Entity Signing Official

SUSAN EHRLICH, CEO
(650) 573-2041

Contract Pharmacy Representative

Raymond Jajeh, President
(650) 360-5300

Signed By Date

3/23/2012