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VALLEY HEALTH CENTER AT VASC PHARMACY
CH09815D South County Community Health Center, Inc.
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Covered Entity Details
Entity Name
South County Community Health Center, Inc.
Subdivision Name
Mayview Community Health Center Mountain VIew a member of Ravenswood Family Health Network
Type
HRSA-Funded Health Center
340B ID
CH09815D
Entity Address
900 Miramonte Ave Fl 2
Mountain View, CA 94040-2457
Grant Number
H80CS00145
Participating Start Date
4/29/2020
Last Recertification Date
2/21/2025
Pharmacy Details
Pharmacy Name
VALLEY HEALTH CENTER AT VASC PHARMACY
Pharmacy Address
2410 Senter Rd Rm 209
San Jose, CA 95111
Pharmacy Comments
Contract Details
Approval Date
4/11/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LUISA BUADA, CEO
(650) 330-7410
Contract Pharmacy Representative
Santa Clara Valley Medical Center
Jecedthel Dumpit, 340B Pharmacist
(408) 885-4442
Signed By Date
4/11/2024
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