Contract Pharmacy Details

HILLCREST PHARMACY
CH091670 VISTA COMMUNITY CLINIC

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

HILLCREST PHARMACY

Pharmacy Address

120 UNIVERSITY AVE
SAN DIEGO, CA 92103

Pharmacy Comments

Contract Details

Approval Date

12/16/2011

Contract Begin Date

12/16/2011

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

11/24/2020
Ownership change

Contacts

Covered Entity Signing Official

Barbara Mannino, CEO
(760) 631-5000

Contract Pharmacy Representative

Susan Baeza, Owner
(619) 260-1010

Signed By Date

9/21/2011