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GARFIELD BEACH CVS, L.L.C.
CH095440 La Maestra Family Clinic, Inc.
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Covered Entity Details
Entity Name
La Maestra Family Clinic, Inc.
Subdivision Name
La Maestra Family clinic
Type
HRSA-Funded Health Center
340B ID
CH095440
Entity Address
4060 Fairmount Ave
San Diego, CA 92105-1608
Grant Number
H80CS00812
Participating Start Date
4/1/2000
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
GARFIELD BEACH CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 09197
9225 TWIN TRAILS DRIVE
SAN DIEGO, CA 92129
Pharmacy Comments
Contract Details
Approval Date
7/13/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
ZARA MARSELIAN, CEO
(619) 584-1612 Ext: 3018
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/13/2021
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