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MISSION PHARMACY
CH09319H TIBURCIO VASQUEZ HEALTH CENTER INCORPORATED
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Covered Entity Details
Entity Name
TIBURCIO VASQUEZ HEALTH CENTER INCORPORATED
Subdivision Name
TIBURCIO VASQUEZ HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH09319H
Entity Address
22331 Mission Blvd
Hayward, CA 94541-3911
Grant Number
H80CS00223
Participating Start Date
9/9/2005
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
MISSION PHARMACY
Pharmacy Address
22138 MISSION BLVD
HAYWARD, CA 94541
Pharmacy Comments
Contract Details
Approval Date
4/7/2010
Contract Begin Date
4/7/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JOSE JOEL GARCIA, CEO
(510) 571-5907
Contract Pharmacy Representative
New Oakland Pharmacy
Kam Tam, Outpatient Pharmacy Manager
(510) 428-3166
Signed By Date
3/25/2010
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