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LARK REXALL DRUGS INC
CH09879S SANTA ROSA COMMUNITY HEALTH CENTERS
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Covered Entity Details
Entity Name
SANTA ROSA COMMUNITY HEALTH CENTERS
Subdivision Name
St. Joseph's Dental Clinic
Type
HRSA-Funded Health Center
340B ID
CH09879S
Entity Address
751 LOMBARDI CT
SANTA ROSA, CA 95407-6798
Grant Number
H80CS00259
Participating Start Date
1/1/2016
Last Recertification Date
2/27/2023
Entity Termination Date
4/1/2024
Pharmacy Details
Pharmacy Name
LARK REXALL DRUGS INC
Pharmacy Address
DBA LARK DRUGS PHARMACY
16251 MAIN ST
GUERNEVILLE, CA 95446-8300
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2024
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Gabriela Bernal Leroi, Chief Executive Officer
(415) 312-9646
Contract Pharmacy Representative
Santa Rose Community Centers
Amalia Nicola, President
(707) 869-9055
Signed By Date
10/16/2023
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