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INDIANA PHARMACY
CH093540 NEIGHBORHOOD HEALTHCARE
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Covered Entity Details
Entity Name
NEIGHBORHOOD HEALTHCARE
Subdivision Name
RAY M. DICKINSON WELLNESS CENTER
Type
HRSA-Funded Health Center
340B ID
CH093540
Entity Address
425 N. DATE ST
ESCONDIDO, CA 92025-3413
Grant Number
H80CS00285
Participating Start Date
4/1/1996
Last Recertification Date
3/6/2025
Pharmacy Details
Pharmacy Name
INDIANA PHARMACY
Pharmacy Address
6780 INDIANA AVENUE
STE 145
RIVERSIDE, CA 92506
Pharmacy Comments
Contract Details
Approval Date
7/1/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
LISA DAIGLE, CFO
(760) 737-6901
Contract Pharmacy Representative
Neighborhood Healthcare
LISA DAIGLE, CFO
(760) 737-6901
Signed By Date
7/1/2024
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