340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AMAZON PHARMACY #010
CH091080 SAN YSIDRO HEALTH CENTER
Print
Covered Entity Details
Entity Name
SAN YSIDRO HEALTH CENTER
Subdivision Name
San Ysidro Health San Ysidro Health Center
Type
HRSA-Funded Health Center
340B ID
CH091080
Entity Address
4004 BEYER BLVD
San Ysidro, CA 92173
Grant Number
H80CS10748
Participating Start Date
12/1/1992
Last Recertification Date
3/4/2025
Pharmacy Details
Pharmacy Name
AMAZON PHARMACY #010
Pharmacy Address
1331 E 6TH ST
CORONA, CA 92879
Pharmacy Comments
Contract Details
Approval Date
1/14/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brian Wallace, VP of Finance & CFO
(619) 662-4100
Contract Pharmacy Representative
PillPack by Amazon Pharmacy
John Lavin, Vice President
(714) 380-0579
Signed By Date
1/14/2025
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session