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PHARMEDQUEST PHARMACY SERVICES
CH09072H NORTH COUNTY HEALTH PROJECT INCORPORATED
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Covered Entity Details
Entity Name
NORTH COUNTY HEALTH PROJECT INCORPORATED
Subdivision Name
TrueCare
Type
HRSA-Funded Health Center
340B ID
CH09072H
Entity Address
1295 CARLSBAD VILLAGE DR, SUITE 100
CARLSBAD, CA 92008-1950
Grant Number
H80CS00228
Participating Start Date
4/1/2015
Last Recertification Date
2/11/2025
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
11/22/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marie Russell, Chief Medical Officer
(760) 736-8689
Contract Pharmacy Representative
Avita
Chris Creamer, COO
(469) 592-2000
Signed By Date
11/22/2022
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