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IMGRX SALUD INC
CH0923660 EL DORADO COUNTY COMMUNITY HEALTH CENTER
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Covered Entity Details
Entity Name
EL DORADO COUNTY COMMUNITY HEALTH CENTER
Subdivision Name
EL DORADO COUNTY COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0923660
Entity Address
4212 Missouri Flat Road
Placerville, CA 95667-6269
Grant Number
H80CS06671
Participating Start Date
1/1/2007
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
IMGRX SALUD INC
Pharmacy Address
DBA EL DORADO COMMUNITY PHARMACY
3100 PONTE MORINO DRIVE, SUITE 120
CAMERON PARK, CA 95682
Pharmacy Comments
Contract Details
Approval Date
9/16/2016
Contract Begin Date
10/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/12/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Judy Stein, CFO
(530) 748-2327
Contract Pharmacy Representative
Cardinal Health
Naveen Mansukhani, National Operations Director
(732) 328-0515
Signed By Date
9/16/2016
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