Contract Pharmacy Details

ALBERTSONS LLC
CH09071C COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.

Covered Entity Details

Entity Name

COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST, INC.

Subdivision Name

DOCTORS OFFICE/FAIR OAKS COMMUNITY HEALTH CENTERS

Type

HRSA-Funded Health Center

340B ID

CH09071C

Entity Address

1057 E GRAND AVE
ARROYO GRANDE, CA 93420-2504

Grant Number

H80CS00621

Participating Start Date

4/1/1997

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

ALBERTSONS LLC

Pharmacy Address

SAV-ON PHARMACY #0314
189 NIBLICK ROAD
PASO ROBLES, CA 93446

Pharmacy Comments

Contract Details

Approval Date

4/3/2023

Contract Begin Date

4/17/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

1/1/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

RONALD E. CASTLE, CEO
(805) 459-1835

Contract Pharmacy Representative

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

Signed By Date

4/3/2023

340B Drug Pricing Program Database