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NATIVIDAD
FQHCLA002G MONTEREY COUNTY DEPT OF HEALTH
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Covered Entity Details
Entity Name
MONTEREY COUNTY DEPT OF HEALTH
Subdivision Name
LAUREL PEDIATRIC CLINIC
Type
Health Center Program Look-Alike
340B ID
FQHCLA002G
Entity Address
1441 CONSTITUTION BLVD, BLDG 200, SUITE 101
SALINAS, CA 93906
Grant Number
LALCS00049
Participating Start Date
4/1/2006
Last Recertification Date
1/31/2019
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
NATIVIDAD
Pharmacy Address
MEDICAL CENTER PHCY
1441 CONSTITUTION BLVD
SALINAS, CA 93906-3100
Pharmacy Comments
Contract Details
Approval Date
12/31/2007
Contract Begin Date
12/31/2007
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
12/27/2007
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