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ELMORE PHARMACY
FQHC638005 GREENVILLE RANCHERIA TRIBAL HEALTH
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Covered Entity Details
Entity Name
GREENVILLE RANCHERIA TRIBAL HEALTH
Subdivision Name
Type
Tribal Contract/Compact with IHS (P.L. 93-638)
340B ID
FQHC638005
Entity Address
410 MAIN STREET
GREENVILLE, CA 95947
Grant Number
Participating Start Date
7/1/2016
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
ELMORE PHARMACY
Pharmacy Address
TEHAMA PHARMACY AND TRADING COMPANY, INC
401 WALNUT ST
RED BLUFF, CA 96080
Pharmacy Comments
Contract Details
Approval Date
2/16/2023
Contract Begin Date
2/21/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Lucretia Fletcher, Tribal Administrator
(530) 528-8600 Ext: 200
Contract Pharmacy Representative
Elmore Pharmacy
Bianca Bradshaw, President
(530) 527-4636
Signed By Date
2/16/2023
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