340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
LAKE PHARMACY
CH09194B MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Print
Covered Entity Details
Entity Name
MENDOCINO COMMUNITY HEALTH CLINIC, INC.
Subdivision Name
LAKEVIEW HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH09194B
Entity Address
5335 Lakeshore Blvd
Lakeport, CA 95453-6123
Grant Number
H80CS00628
Participating Start Date
4/1/2011
Last Recertification Date
2/25/2025
Pharmacy Details
Pharmacy Name
LAKE PHARMACY
Pharmacy Address
15230 LAKESHORE DR
CLEARLAKE, CA 95422
Pharmacy Comments
Contract Details
Approval Date
10/24/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rod Grainger, CEO
(707) 472-4667
Contract Pharmacy Representative
Lake Pharmacy
Tim Nguyen, Owner
(707) 994-3141
Signed By Date
10/24/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session