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MED CARE PHARMACY
CH09167C VISTA COMMUNITY CLINIC
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Covered Entity Details
Entity Name
VISTA COMMUNITY CLINIC
Subdivision Name
VCC: GRAPEVINE
Type
HRSA-Funded Health Center
340B ID
CH09167C
Entity Address
134 GRAPEVINE RD.
VISTA, CA 92083-4004
Grant Number
H80CS00282
Participating Start Date
4/1/1996
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
MED CARE PHARMACY
Pharmacy Address
MED MATRIX PHARMACY , INC
161 THUNDER DR STE 100
VISTA, CA 92083
Pharmacy Comments
Contract Details
Approval Date
7/12/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Michele Lambert, CFO
(760) 216-5803
Contract Pharmacy Representative
Med Care Pharmacy
Connie Dao, Chief Pharmacist
(760) 536-3323
Signed By Date
7/12/2023
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