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ALTO PHARMACY LLC
STD95503 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
Planned Parenthood Eureka
Type
Sexually Transmitted Diseases
340B ID
STD95503
Entity Address
3225 Timber Fall Ct.
Suite B
Eureka, CA 95503
Grant Number
1H25PS005127
Participating Start Date
4/1/2015
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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