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SIERRA VISTA PHARMACY, INC.
CH09364C FAMILY HEALTHCARE NETWORK
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Covered Entity Details
Entity Name
FAMILY HEALTHCARE NETWORK
Subdivision Name
FAMILY HEALTHCARE NETWORK - WOODLAKE HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH09364C
Entity Address
201 E. Lakeview Avenue
Woodlake, CA 93286
Grant Number
H80CS00786
Participating Start Date
4/1/2002
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
SIERRA VISTA PHARMACY, INC.
Pharmacy Address
650 E VISALIA RD
FARMERSVILLE, CA 93223
Pharmacy Comments
Contract Details
Approval Date
7/13/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kerry Hydash, President and CEO
(559) 737-4700
Contract Pharmacy Representative
Sierra Vista Pharmacy
Feby Salem, owner
(559) 594-8602
Signed By Date
7/13/2024
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