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ALTO PHARMACY, LLC
STD95422 PLANNED PARENTHOOD SHASTA-DIABLO, INC. DBA PLANNED PARENTHOOD NORTHERN CALIFORNIA
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Covered Entity Details
Entity Name
PLANNED PARENTHOOD SHASTA-DIABLO, INC. DBA PLANNED PARENTHOOD NORTHERN CALIFORNIA
Subdivision Name
CLEARLAKE CENTER
Type
Sexually Transmitted Diseases
340B ID
STD95422
Entity Address
14671 OLYMPIC DR.
CLEARLAKE, CA 95422
Grant Number
1H25PS005127
Participating Start Date
7/1/2014
Last Recertification Date
5/23/2025
Pharmacy Details
Pharmacy Name
ALTO PHARMACY, LLC
Pharmacy Address
DBA ALTO PHARMACY
1400 TENNESSEE ST UNIT 2
SAN FRANCISCO, CA 94107-3421
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michelle Horne, Vice President of Patient Services
(925) 412-2381
Contract Pharmacy Representative
Alto Pharmacy
Jaime LaFontaine, Director of Enterprise
(916) 539-4587
Signed By Date
10/15/2021
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