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ALTO PHARMACY LLC
STD94109 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 FRANCISCO FLAGSHIP
Type
Sexually Transmitted Diseases
340B ID
STD94109
Entity Address
1522 BUSH STREET
SAN FRANCISCO, CA 94109-5420
Grant Number
NH25PS005141-01-00
Participating Start Date
10/1/2020
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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