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PREFERRED PHARMACY
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
PREFERRED PHARMACY
Pharmacy Address
1601 N IMPERIAL AVE STE B
EL CENTRO, CA 92243
Pharmacy Comments
Contract Details
Approval Date
1/18/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/20/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
YVONNE BELL, CEO
(760) 344-9951 Ext: 10102
Contract Pharmacy Representative
BP Mukhi Inc
Bhavik Patel, Owner
(760) 592-4650
Signed By Date
1/18/2017
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