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MEDICAL CENTER PHARMACY
CH093120 FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
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Covered Entity Details
Entity Name
FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
Subdivision Name
Logan Heights Family Health Center
Type
HRSA-Funded Health Center
340B ID
CH093120
Entity Address
1809 National Ave
San Diego, CA 92113-2113
Grant Number
H80CS00224
Participating Start Date
12/1/1992
Last Recertification Date
3/1/2025
Pharmacy Details
Pharmacy Name
MEDICAL CENTER PHARMACY
Pharmacy Address
4074 FAIRMONT AVENUE
SAN DIEGO, CA 92105
Pharmacy Comments
Contract Details
Approval Date
8/9/2011
Contract Begin Date
8/9/2011
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/19/2018
Ownership change
Contacts
Covered Entity Signing Official
Fran Butler-Cohen, CEO
(619) 515-2301
Contract Pharmacy Representative
George Awad, Pharmacy Director
(619) 997-4702
Signed By Date
7/26/2011
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