Contract Pharmacy Details

ALBERTSONS LLC
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

ALBERTSONS LLC

Pharmacy Address

SAV-ON PHARMACY # 0733
3450 MARRON RD
OCEANSIDE, CA 92056

Pharmacy Comments

Contract Details

Approval Date

4/12/2017

Contract Begin Date

7/1/2017

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Fernando Sanudo, CEO
(760) 631-5000 Ext: 4

Contract Pharmacy Representative

Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304

Signed By Date

4/12/2017

340B Drug Pricing Program Database