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CAPITOL PHARMACY, INC.
CHC24113-13 ELICA HEALTH CENTERS
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Covered Entity Details
Entity Name
ELICA HEALTH CENTERS
Subdivision Name
Elica Health Centers - Halyard Medical Center
Type
HRSA-Funded Health Center
340B ID
CHC24113-13
Entity Address
1276 Halyard Dr
West Sacramento, CA 95691
Grant Number
H80CS24113
Participating Start Date
4/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
CAPITOL PHARMACY, INC.
Pharmacy Address
CAPITOL PHARMACY
1250 HARBOR BLVD STE 600
WEST SACRAMENTO, CA 95691
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David E Hughes, COO/CFO
(916) 569-8484 Ext: 312
Contract Pharmacy Representative
Capitol Pharmacy
Tom Bui, Owner
(916) 617-4321
Signed By Date
10/16/2023
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