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WESTSIDE DRUG COMPANY
CH09056AQ UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
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Covered Entity Details
Entity Name
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Subdivision Name
United Health Centers Mendota Barboza 119 Building 1
Type
HRSA-Funded Health Center
340B ID
CH09056AQ
Entity Address
119 Barboza St
Mendota, CA 93640-1901
Grant Number
H80CS00137
Participating Start Date
10/1/2024
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
WESTSIDE DRUG COMPANY
Pharmacy Address
1101 O ST
FIREBAUGH, CA 93622-2224
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Navjot Singh, Contracting & Managed Care Officer
(559) 646-6618 Ext: 0039
Contract Pharmacy Representative
Westside Drug Company
Jeff Louie, Treasurer
(559) 659-2159
Signed By Date
7/15/2024
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