Contract Pharmacy Details

THE VONS COMPANIES INC
CH09365A CLINICAS DEL CAMINO REAL, INC.

Covered Entity Details

Entity Name

CLINICAS DEL CAMINO REAL, INC.

Subdivision Name

Clinicas Del Camino Real Inc - Fillmore

Type

HRSA-Funded Health Center

340B ID

CH09365A

Entity Address

355 Central Ave
Fillmore, CA 93015-1920

Grant Number

H80CS00550

Participating Start Date

7/1/1995

Last Recertification Date

2/12/2025

Pharmacy Details

Pharmacy Name

THE VONS COMPANIES INC

Pharmacy Address

PAVILIONS PHARMACY #2228
1213 FAIR OAKS AVENUE
SOUTH PASADENA, CA 91030

Pharmacy Comments

Contract Details

Approval Date

7/17/2023

Contract Begin Date

10/1/2023

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

8/9/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Robert Streeter, Chief Medical Officer
(805) 659-1740

Contract Pharmacy Representative

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

Signed By Date

7/17/2023

340B Drug Pricing Program Database