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WESTERN PHARMACY GROUP LLC
CH101030 YAKIMA VALLEY FARM WORKERS CLINIC
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Covered Entity Details
Entity Name
YAKIMA VALLEY FARM WORKERS CLINIC
Subdivision Name
YVFWC - TOPPENISH
Type
HRSA-Funded Health Center
340B ID
CH101030
Entity Address
510 W 1st Ave
Toppenish, WA 98948-1564
Grant Number
H80CS00639
Participating Start Date
12/1/1992
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
WESTERN PHARMACY GROUP LLC
Pharmacy Address
DBA COMMUNITY MEDICAL CENTER PHARMACY
610 GATEWAY CENTER WAY
SUITES A--E
SAN DIEGO, CA 92102
Pharmacy Comments
Contract Details
Approval Date
7/15/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Agreement registered in error
Contacts
Covered Entity Signing Official
JUAN CARLOS OLIVARES, CEO
(509) 865-5898 Ext: 2101
Contract Pharmacy Representative
Western Pharmacy Group LLC
KEVIN FARIS, CEO
(360) 685-4263
Signed By Date
7/15/2021
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