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THE VONS COMPANIES INC
CH09025T CLINICAS DE SALUD DEL PUEBLO, INC
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Covered Entity Details
Entity Name
CLINICAS DE SALUD DEL PUEBLO, INC
Subdivision Name
Innercare Brawley Dental
Type
HRSA-Funded Health Center
340B ID
CH09025T
Entity Address
283 Main Street, Suite 102
Brawley, CA 92227
Grant Number
H80CS00733
Participating Start Date
10/1/2024
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
THE VONS COMPANIES INC
Pharmacy Address
VONS PHARMACY #2406
750 NORTH IMPERIAL AVENUE
EL CENTRO, CA 92243
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
YVONNE BELL, CEO
(760) 344-9951 Ext: 10102
Contract Pharmacy Representative
THE VONS COMPANIES INC
Matt Vian, 340B Program Administrator
(623) 869-3454
Signed By Date
1/14/2025
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