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EXACT CARE PHARMACY
CH092500 IMPERIAL BEACH COMMUNITY CLINIC
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Covered Entity Details
Entity Name
IMPERIAL BEACH COMMUNITY CLINIC
Subdivision Name
IMPERIAL BEACH HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH092500
Entity Address
949 Palm Ave
Imperial Beach, CA 91932-1503
Grant Number
H80CS06648
Participating Start Date
4/1/1996
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
EXACT CARE PHARMACY
Pharmacy Address
DDCRX, LLC
2701 HIGHPOINT OAKS DR STE 100
LEWISVILLE, TX 75067-3896
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Clinton Carroll Wiese, CFO
(619) 429-3733 Ext: 403
Contract Pharmacy Representative
Exaxtcare
Sarah L Fenwick, Senior Vice President of Network Contracting
(216) 369-2200 Ext: 5067
Signed By Date
4/15/2022
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