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ALBERTSONS LLC
CH09167R VISTA COMMUNITY CLINIC
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Covered Entity Details
Entity Name
VISTA COMMUNITY CLINIC
Subdivision Name
VCC: Lake Elsinore Health Center
Type
HRSA-Funded Health Center
340B ID
CH09167R
Entity Address
31361 Riverside Dr
Lake Elsinore, CA 92530-7807
Grant Number
H80CS00282
Participating Start Date
1/1/2024
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
ALBERTSONS LLC
Pharmacy Address
SAV-ON PHARMACY # 2767
3925 MISSION AVE
OCEANSIDE, CA 92058
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
Michele Lambert, CFO
(760) 216-5803
Contract Pharmacy Representative
Albertsons Companies
Chuck Hanson, Senior 340B Program Manager
(208) 395-6304
Signed By Date
10/16/2023
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