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ALTO PHARMACY LLC
STD94583 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
SAN RAMON CENTER
Type
Sexually Transmitted Diseases
340B ID
STD94583
Entity Address
200 Porter Drive
Suite 200
SAN RAMON, CA 94583
Grant Number
1H25PS005127
Participating Start Date
4/1/2004
Last Recertification Date
5/6/2024
Pharmacy Details
Pharmacy Name
ALTO PHARMACY LLC
Pharmacy Address
DBA ALTO PHARMACY
2360 QUME DR
STE A
SAN JOSE, CA 95131
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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