340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
TED'S VILLAGE PHARMACY INC
CH09114E SAN MATEO MEDICAL CENTER
Print
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
TED'S VILLAGE PHARMACY INC
Pharmacy Address
29 W 25TH AVE
SAN MATEO, CA 94403-2236
Pharmacy Comments
Contract Details
Approval Date
4/15/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/29/2017
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
SUSAN EHRLICH, CEO
(650) 573-2041
Contract Pharmacy Representative
Signed By Date
4/15/2015
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session