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MERCY CARE 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
MERCY CARE PHARMACY
Pharmacy Address
488 E VALLEY PKWY STE 101
ESCONDIDO, CA 92025
Pharmacy Comments
Contract Details
Approval Date
1/6/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Ricardo Roman, CFO
(619) 906-4603
Contract Pharmacy Representative
MERCY CARE PHARMACY
Bassam Massaad, Pharmacist/Owner
(760) 294-0014
Signed By Date
1/6/2017
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