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BLYTHE DRUG JS INC
CH090250 CLINICAS DE SALUD DEL PUEBLO,Inc.
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Covered Entity Details
Entity Name
CLINICAS DE SALUD DEL PUEBLO,Inc.
Subdivision Name
Innercare K Street
Type
HRSA-Funded Health Center
340B ID
CH090250
Entity Address
1166 K St
Brawley, CA 92227-2737
Grant Number
H80CS00733
Participating Start Date
12/1/1992
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
BLYTHE DRUG JS INC
Pharmacy Address
BLYTHE DRUG
301 W HOBSONWAY
BLYTHE, CA 92225
Pharmacy Comments
Contract Details
Approval Date
4/1/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/14/2018
Ownership change
Contacts
Covered Entity Signing Official
YVONNE BELL, CEO
(760) 344-9951 Ext: 10102
Contract Pharmacy Representative
J & R Unity Inc.
Chaehoon Song, President
(760) 922-3511
Signed By Date
4/1/2014
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