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PHARMEDQUEST PHARMACY SERVICES
CH091670 VISTA COMMUNITY CLINIC
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Covered Entity Details
Entity Name
VISTA COMMUNITY CLINIC
Subdivision Name
VCC: VALE TERRACE
Type
HRSA-Funded Health Center
340B ID
CH091670
Entity Address
1000 Vale Terrace Dr.
Vista, CA 92084-5218
Grant Number
H80CS00282
Participating Start Date
4/1/1996
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
PHARMEDQUEST PHARMACY SERVICES
Pharmacy Address
DBA AVITA PHARMACY 1072
26800 CROWN VALLEY PKWY STE 185
MISSION VIEJO, CA 92691
Pharmacy Comments
Contract Details
Approval Date
4/18/2022
Contract Begin Date
5/6/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michele Lambert, CFO
(760) 216-5803
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
4/18/2022
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