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SHIVOM CORPORATION
CH090390 CLINICA SIERRA VISTA
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Covered Entity Details
Entity Name
CLINICA SIERRA VISTA
Subdivision Name
CORPORATE HQ - CLINICA SIERRA VISTA
Type
HRSA-Funded Health Center
340B ID
CH090390
Entity Address
1430 Truxtun Ave STE 400
Bakersfield, CA 93301
Grant Number
H80CS00540
Participating Start Date
1/1/2004
Last Recertification Date
3/3/2025
Pharmacy Details
Pharmacy Name
SHIVOM CORPORATION
Pharmacy Address
DBA: MING PLAZA PHARMACY
2726 MING AVE STE A
BAKERSFIELD, CA 93304
Pharmacy Comments
Contract Details
Approval Date
10/21/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Harjeet Sidhu, Senior Director of Finance
(661) 635-3050 Ext: 2145
Contract Pharmacy Representative
Ming Plaza Pharmacy
Rajesh Khosla, Pharmacy Manager
(661) 545-6464
Signed By Date
10/21/2022
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